This study provides an objective comparison of cranial computed tomography (CT) imaging quality and radiation dose between photon counting detectors (PCCTs) and energy-integrated detectors (EIDs). We retrospectively analyzed 158 CT scans from 76 patients, employing both detector types on the same individuals to ensure a consistent comparison. Our analysis focused on the Computed Tomography Dose Index and the Dose-Length Product together with the contrast-to-noise ratio and the signal-to-noise ratio for brain gray and white matter. We utilized standardized imaging protocols and consistent patient positioning to minimize variables. PCCT showed a potential for higher image quality and lower radiation doses, as highlighted by this study, thus achieving diagnostic clarity with reduced radiation exposure, underlining its significance in patient care, particularly for patients requiring multiple scans. The results demonstrated that while both systems were effective, PCCT offered enhanced imaging and patient safety in neuroradiological evaluations.

Background: Advances in computed tomography (CT) technology, particularly photon-counting CT (PCCT), are reshaping the possibilities for medical imaging. PCCT in spectral imaging enables the high-resolution visualization of tissues with material-specific accuracy. This study aims to establish a foundational approach for the in vivo visualization of intracranial blood using PCCT, focusing on non-enhanced imaging techniques and spectral imaging capabilities. Methods: We employed photon-counting detector within a spectral CT framework to differentiate between venous and arterial intracranial blood. Our analysis included not only monoenergetic +67 keV reconstructions, but also images from virtual non-contrast and iodine phases, enabling detailed assessments of blood’s characteristics without the use of contrast agents. Results: Our findings demonstrate the ability of PCCT to provide clear and distinct visualizations of intracranial vascular structures. We quantified the signal-to-noise ratio across different imaging phases and found consistent enhancements in image clarity, particularly in the detection and differentiation of arterial and venous blood. Conclusion: PCCT offers a robust platform for the non-invasive and detailed visualization of intravascular intracranial blood. With its superior resolution and specific imaging capabilities, PCCT lays the groundwork for advancing clinical applications and research, notably in the diagnosis and management of intracranial disorders. This technology promises to improve diagnostic accuracy by enabling more precise imaging assessments.

Background: Recent advancements in computed tomography (CT), notably in photon-counting CT (PCCT), are revolutionizing the medical imaging field. PCCT’s spectral imaging can better visualize tissues based on their material properties. This research aims to establish a fundamental approach for the in vivo visualization of intracranial cerebrospinal fluid (CSF) using PCCT. Methods: PCCT was integrated to distinguish the CSF within the intracranial space with spectral imaging. In this study, we analyzed monoenergetic +67 keV reconstructions alongside virtual non-contrast and iodine phase images. This approach facilitated the assessment of the spectral characteristics of CSF in patients who did not present with intra-axial pathology or inflamation. Results: Our findings illustrate PCCT’s effectiveness in providing distinct and clear visualizations of intracranial CSF structures, building a foundation. The signal-to-noise ratio was quantified across all measurements, to check in image quality. Conclusions: PCCT serves as a robust, non-invasive platform for the detailed visualization of intracranial CSF. This technology is promising in enhancing diagnostic accuracy through different conditions.