# Physics and rationale in pediatric abdomen photon counting detector computed tomography: an investigative review towards development of a pediatric abdomen protocol

## TL;DR

This paper reviews and develops a pediatric abdomen protocol for photon counting detector CT to improve safety and image quality in children.

## Contribution

The paper proposes a pediatric abdomen protocol for PCD-CT and provides early clinical insights for adapting it.

## Key findings

- A pediatric abdominal PCD-CT protocol was derived for children up to 12 years.
- Progressively complex phantoms were used to test key PCD-CT parameters.
- Preliminary clinical results support the proposed protocol's adaptability.

## Abstract

The advent of photon counting detector computed tomography (PCD-CT) holds the promise of radiation reduction, improved spatial resolution, and spectral data for material decomposition in pediatric abdominal radiology, but effort is required to achieve this. Consensus lacks on what a good pediatric abdominal protocol should entail, and new features and hardware require a learning curve. This investigative review addresses and investigates the key software and hardware parameters of PCD-CT by testing progressively complex phantoms. Based on these tests, a pediatric abdominal PCD-CT protocol was derived for children up to 12 years, and preliminary clinical results are presented. Pediatric radiologists adopting PCD-CT can benefit from our early experience and use this review to adapt the proposed protocol to their needs.

The online version contains supplementary material available at 10.1007/s00247-025-06274-7.