ArticleAbdominal radiology (New York)2026
Diagnostic performance of photon-counting detector CT versus energy-integrating detector CT for colorectal polyp detection: a phantom study.
Article in Abdominal radiology (New York), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo compare the diagnostic performance of photon-counting detector CT (PCD-CT) and energy-integrating detector CT (EID-CT) for colorectal polyp detection using a phantom model with histopathologically verified polyps.
methodsA phantom containing 84 histopathologically confirmed colorectal polyps from resected specimens underwent sequential PCD-CT and EID-CT scanning. Polyps were categorized by size as ≤ 5 mm, 6-9 mm, or ≥ 10 mm. Two blinded abdominal radiologists evaluated image quality (5-point Likert scale), quantitative metrics (signal-to-noise ratio [SNR], contrast-to-noise ratio [CNR]), detection sensitivity, and diagnostic confidence (3-point scale). Wilcoxon signed-rank and paired t-tests compared image quality parameters, McNemar's test compared detection rates, and inter-reader agreement was assessed using ICC and kappa statistics.
resultsPCD-CT demonstrated significantly superior qualitative image quality compared to EID-CT, with higher scores for overall quality (5 [4, 5] vs. 3 [3, 4]), sharpness (5 [4, 5] vs. 3 [1, 4]), and lower noise levels (5 [4, 5] vs. 3 [3, 3]) (all p < 0.001).Quantitative analysis showed superior SNR and CNR across all polyp sizes (all p < 0.001), with the most pronounced improvement in ≤ 5 mm polyps (SNR: 143% increase, CNR: 149% increase). PCD-CT significantly improved detection rates for ≤ 5 mm (71.4% vs. 17.9%, p < 0.001) and 6-9 mm polyps (92.9% vs. 71.4%, p = 0.031). Reader confidence was also significantly higher with PCD-CT for ≤ 5 mm (p < 0.001) and 6-9 mm (p < 0.001) polyps, with substantial inter-reader agreement (kappa = 0.858; 95% CI:0.703-0.906).
conclusionPCD-CT provides significantly improved diagnostic accuracy for colorectal polyp detection compared to EID-CT, with substantial gains in small polyp sensitivity and overall image quality.
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