ESOC 2026 | Clinical applications of photon-counting CT in stroke assessment

So, within stroke, you have non-contrast CT, you have CTA, but also post-stroke imaging. So, if you look to non-contrast CT, because you have less noise, the images are more easily interpreted. And if you want to have a better appreciation, for example, for ischemia or for hemorrhage, you can play around with the energies afterwards. So you can reconstruct images at higher mono-energetic energies, and then the conspicuity of infarctions and hemorrhages is more easy. But you can imagine maybe we can do it also now. But if you look to CTA and with CTA you can make more… With CTA you have the better conspicuity of the vessels because you have a higher resolution. So the LVO detection probably will be the same, although people could be more at ease with it. But you can also see the smaller occlusions better than with conventional CT. So with photon-counting CT, we appreciate more distal occlusions than we would do with the energy integrating detector CT. And of course, after the endovascular procedure, now you can sometimes have the trouble of having a high density after the procedure. So would you think it’s iodine from the interventional procedure or is it hemorrhage as a complication but with dual energy CT and also thus with photon-counting CT you can differentiate hemorrhage from iodine and you can be sure if it’s a hemorrhage or is it still iodine so the patient is not at risk.

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