PCD-CT vs. Dual-Energy CT in Pediatric Body Imaging: A Single-Center Experience

BACKGROUND: Photon-counting CT (PCCT) may improve dose efficiency compared with Energy-Integrating Detector (EID-CT), but pediatric evidence is mainly limited to small, protocol-matched studies. Real-world comparisons with existing departmental EID scanners remain scarce.

OBJECTIVES: To compare radiation dose of contrast-enhanced pediatric chest, chest–abdomen and abdominal CT across one PCD-CT and two state of the art dual-source EID-CT scanners, at a single tertiary center, stratified by age group.

RESULTS: We analyzed 537 consecutive contrast-enhanced scans in children aged 0–17 years, performed on a NAEOTOM Alpha (PCD-CT, n=70), a Somatom Force (EID-CT, n=274) and an emergency-department Somatom Drive (EID-CT, n=193), each scan of a multi-phase examination counted separately. Scanners were compared by Kruskal–Wallis’s testing with Dunn post-hoc analysis and Bonferroni correction. Dose differed across scanners for every scan type (all p≤0.001). For chest CT, median DLP was 10.8 mGy·cm on PCD-CT versus 24.6 and 100.2 mGy·cm on Force and Drive, and median CTDIvol 0.5 versus 0.8 and 3.1 mGy; PCD-CT was lower than both EID scanners after correction (versus Force p=0.002 and p=0.003; versus Drive both p<0.001). For abdominal CT, median DLP was 78.7 versus 105.2 and 160.6 mGy·cm; PCD-CT was significantly lower than the Drive (p=0.001) but not the Force (p=0.23). Chest–abdomen CT showed the same pattern.

CONCLUSIONS: PCD-CT delivered significantly lower doses than existing dual-source EID scanners, for multiple body applications, notably, compared to the Drive.