# Photon-Counting CT in Musculoskeletal Radiology: Technical Principles, Clinical Applications, and Future Directions

**Authors:** Stijn De Bondt, Ione Limantoro, Hilde Bosmans, Geert Maleux, Nathalie Noppe, Michiel Herteleer

PMC · DOI: 10.5334/jbsr.4190 · Journal of the Belgian Society of Radiology · 2026-02-20

## TL;DR

Photon-counting CT improves imaging in musculoskeletal radiology by reducing artifacts, enhancing bone marrow visualization, and lowering radiation dose.

## Contribution

This paper reviews the clinical applications and benefits of photon-counting CT in musculoskeletal radiology.

## Key findings

- Photon-counting CT reduces metal artifacts and improves diagnostic accuracy.
- It enhances visualization of bone marrow edema and crystal arthropathies.
- The technology allows for significant radiation dose reduction.

## Abstract

Photon-counting computed tomography is the newest technological advancement in CT imaging allowing for an improved spatial resolution, inherent spectral information, and significant radiation dose reduction. These benefits may enhance diagnostic confidence and accuracy for radiologists and clinicians. Multiple clinical applications in musculoskeletal radiology benefit from this technology, including the reduction of metal artifacts, improved visualization of bone marrow edema, and better assessment of crystal arthropathies. This narrative review presents a comprehensive summary of the current advancements and applications of this emerging technology within musculoskeletal radiology using several illustrative cases.

## Linked entities

- **Species:** Mus musculus (taxon 10090)

## Full-text entities

- **Diseases:** osteopenia (MESH:D001851), sclerosis (MESH:D012598), obese (MESH:D009765), Osteoarthritis (MESH:D010003), acute knee trauma (MESH:D000208), osteolytic lesion (MESH:D030981), post-traumatic fractures (MESH:D004834), osteosarcoma (MESH:D012516), Skeletal trauma (MESH:D014947), hip pain (MESH:D010146), fracture (MESH:D050723), gout (MESH:D006073), MM (MESH:D009101), cancer (MESH:D009369), BME (MESH:D004487), musculoskeletal (MESH:D009140), PCCT (MESH:C000719218), PCD (MESH:D009845), ligamentous or muscle injury (MESH:D009135), MSU (MESH:C562377), cortical (MESH:D054220), osteomyelitis (MESH:D010019), Crystal arthropathies (MESH:D000070657), CPPD (MESH:D002805), Soft tissue injury (MESH:D017695), femoral bone metastasis (MESH:D009362), hip fracture (MESH:D006620), loosening (MESH:D011475), bone marrow lesions (MESH:D001855), knee osteoarthritis (MESH:D020370), bone lesions (MESH:D001847), bone or soft tissue tumors (MESH:D012983), CPP (MESH:D020288), Osteoporosis (MESH:D010024)
- **Chemicals:** tin (MESH:D014001), MSU (MESH:D014527), calcium (MESH:D002118), PCCT (-), silicon (MESH:D012825), cadmium telluride (MESH:C028337), HA (MESH:D017886)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

8 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12922662/full.md

## References

78 references — full list in the complete paper: https://tomesphere.com/paper/PMC12922662/full.md

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Source: https://tomesphere.com/paper/PMC12922662