Photon-Counting CT in Cancer Radiotherapy: Technological Advances and Clinical Benefits

TL;DR

Photon-counting CT offers significant improvements in imaging quality, dose reduction, and multi-energy capabilities, enhancing precision and safety in cancer radiotherapy with promising clinical applications and ongoing technological advancements.

Contribution

This review comprehensively discusses technological advances in photon-counting CT and their clinical benefits in cancer radiotherapy, highlighting its potential to transform treatment practices.

Findings

Superior spatial and contrast resolution of PCCT

Reduced radiation dose in imaging procedures

Emerging clinical applications in brachytherapy and RPT

Abstract

Photon-counting computed tomography (PCCT) marks a significant advancement over conventional energy-integrating detector (EID) CT systems. This review highlights PCCT's superior spatial and contrast resolution, reduced radiation dose, and multi-energy imaging capabilities, which address key challenges in radiotherapy, such as accurate tumor delineation, precise dose calculation, and treatment response monitoring. PCCT's improved anatomical clarity enhances tumor targeting while minimizing damage to surrounding healthy tissues. Additionally, metal artifact reduction (MAR) and quantitative imaging capabilities optimize workflows, enabling adaptive radiotherapy and radiomics-driven personalized treatment. Emerging clinical applications in brachytherapy and radiopharmaceutical therapy (RPT) show promising outcomes, although challenges like high costs and limited software integration remain. With advancements in artificial intelligence (AI) and dedicated radiotherapy packages, PCCT is poised to transform precision, safety, and efficacy in cancer radiotherapy, marking it as a pivotal technology for future clinical practice.