Photon-counting CT vs. energy-integrating detector CT: image quality and radiation dose in multi-phase abdominopelvic imaging

Abstract Objective To compare photon-counting detector CT (PCCT) and energy-integrating detector CT (EID-CT) for abdominopelvic imaging regarding radiation dose and image quality. Methods This prospective study enrolled 94 adults undergoing abdominopelvic CT. Objective image quality was assessed by measuring hepatic noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). Two blinded radiologists independently scored subjective image quality using a 5-point Likert scale. Radiation exposure was evaluated via CTDIvol, dose-length product (DLP), and scan length–normalized DLP (nDLP). Results PCCT significantly reduced radiation dose: CTDIvol by 57%, DLP by 62%, and nDLP by 57% (all P .001). Concurrently, image quality improved:hepatic noise decreasing by 31% (P .001), and SNR increased by 40–70% (P .001); CNR increased 22–45% (P .05). Conclusion PCCT achieves substantial radiation dose reduction while improving objective image quality compared with EID-CT in abdominopelvic imaging. These findings support PCCT as a valuable tool for dose-optimised abdominal protocols.