ArticleEuropean radiology experimental2026
Next-gen paediatric imaging: ultra-low dose chest photon-counting CT approaching chest radiograph doses.
Article in European radiology experimental, 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
objectivePhoton-counting detector (PCD) CT may reduce radiation dose while maintaining image quality, which is particularly promising for children due to their radiosensitivity. This feasibility study investigated whether an ultra-low dose CT (ULDCT) chest protocol on PCD CT, with a dose comparable to chest radiographs, could be developed to detect gross lung abnormalities in children. MATERIALS AND
methodsThis ethics-approved retrospective study consisted of two parts: (1) development of a ULDCT chest protocol using an anthropomorphic phantom and (2) qualitative evaluation of these scans performed in 24 consecutive patients (< 16 years) for various indications. Two paediatric radiologists assessed diagnostic quality for six chest pathologies using a 3-point Likert scale. Radiation dose metrics were extracted from a dose management system, and effective doses (ED) were calculated using age-appropriate conversion factors. Statistical analysis included mainly descriptive calculations. Doses were compared with routine chest radiography.
resultsThe Lungman phantom was scanned using 5 different protocols. The optimal settings were identified as Sn100 kVp, 2 mAs and pitch 1.5, yielding an ED of 14 µSv. All paediatric scans were assessed as acceptable, but a preference for an increased dose protocol was given to rule out interstitial lung disease or bronchiectasis. The mean total ED from the localiser and ULDCT of the chest was 11.6 [IQR: 10.9-12.8] µSv compared to 8.2 [IQR: 6.2-13.6] µSv for standard chest radiography.
conclusionOur PCD ULDCT chest protocol, approaching chest radiograph doses, is promising for (follow-up of) focal abnormalities and follow-up imaging of known chest pathology in children. KEY POINTS: Question Can the technique of photon-counting detector CT result in radiation dose reduction, while achieving adequate image quality? Findings An ultra-low dose CT chest protocol was developed with a comparable dose to a single chest radiograph. Relevance statement The ultra-low dose CT chest protocol is promising in the setting of (follow-up of known) focal chest abnormalities, long-term follow-up after congenital diaphragmatic hernia repair and follow-up of interstitial lung disease in children.
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