Neuroimaging with photon-counting computed tomography: A review of clinical applications

Table 2 Summary of established clinical neuroimaging applications of photon-counting computed tomography, along with the key properties of photon-counting computed tomography that provide benefits over conventional computed tomography

Clinical application	Key properties of PCCT	Advantages in neurology
Neurovascular imaging	High spatial resolution, reduction of blooming artifacts, enhanced visualization of stents and metallic implants	Improved evaluation of tiny intracranial vessels, arterial stenoses, and vascular stents; reduced artifacts near the skull base
Acute ischemic stroke	Superior signal-to-noise ratio, enhanced grey-white matter contrast	Early detection of ischemic changes, differentiation of hemorrhage from contrast media
Spinal CSF leaks and fistulas	Enhanced resolution, virtual monoenergetic imaging	Precise detection of CSF leaks and venous fistulas, reduced radiation exposure
Deep brain stimulation electrode imaging	Ultra-high resolution, reduced noise, clear visualization of segmented contacts	Accurate postoperative assessment of electrode placement and orientation
Middle and internal ear pathologies	Superior in-plane resolution, thinner section thickness	Enhanced visualization of ossicular chains, dislocations, and cochlear implant positioning
Atherosclerotic plaque characterization	Material differentiation through spectral imaging	Improved detection of rupture-prone plaques and assessment of intraplaque hemorrhage and lipid content
Post-treatment monitoring (Aneurysms and stents)	High-resolution imaging, reduced blooming artifacts	Detailed visualization of stent apposition, in-stent stenoses, and aneurysm occlusion devices
Cranial and spinal tumors	Enhanced contrast-to-noise ratio, soft-tissue resolution	Better delineation of tumor margins and detection of smaller lesions

PCCT: Photon-counting computed tomography; CSF: Cerebrospinal fluid.