Shah Keyur D, Zhou Jun, Roper Justin, Dhabaan Anees, Al-Hallaq Hania, Pourmorteza Amir, Yang Xiaofeng
Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA 30322, United States of America.
Department of Radiology and Imaging Sciences and Winship Cancer Institute, Emory University, Atlanta, GA 30322, United States of America.
Phys Med Biol. 2025 May 16;70(10):10TR01. doi: 10.1088/1361-6560/add4ba.
Photon-counting computed tomography (PCCT) marks a significant advancement over conventional Energy-integrating detector 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 and quantitative imaging capabilities optimize workflows, enabling ART and radiomics-driven personalized treatment. Emerging clinical applications in brachytherapy and radiopharmaceutical therapy show promising outcomes, although challenges like high costs and limited software integration remain. With advancements in artificial intelligence 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.
光子计数计算机断层扫描（PCCT）标志着相对于传统能量积分探测器CT系统的重大进步。本综述强调了PCCT卓越的空间和对比度分辨率、降低的辐射剂量以及多能量成像能力，这些能力解决了放射治疗中的关键挑战，如精确的肿瘤轮廓勾画、精确的剂量计算和治疗反应监测。PCCT改善的解剖清晰度增强了肿瘤靶向性，同时将对周围健康组织的损伤降至最低。此外，减少金属伪影和定量成像能力优化了工作流程，实现了基于人工智能和放射组学的个性化治疗。近距离放射治疗和放射性药物治疗中的新兴临床应用显示出了有前景的结果，尽管高成本和软件集成有限等挑战仍然存在。随着人工智能和专用放射治疗软件包的进步，PCCT有望改变癌症放射治疗的精准性、安全性和有效性，使其成为未来临床实践的关键技术。
