Direct Comparison of Photon Counting-Ct and Conventional Ct in Image Quality of Lung Nodules: A Systematic Review and Meta-Analysis Publisher Pubmed



Mohammadzadeh S^{1, 2} ; Mohebbi A^{1, 2} ; Kiani I^{1, 2} ; Mohammadi A³
Source: European Journal of Radiology Published:2025

Abstract

Purpose: To evaluate and compare lung nodules’ image quality and radiation dose exposure using photon-counting computed tomography (PC-CT) and conventional energy-integrating detector computed tomography (EID-CT). Methods: Protocol pre-registration was performed a priori at (https://osf.io/krj5y/). We searched PubMed, Web of Science, Embase, and Cochrane Library for studies until April 10, 2024. Risk of bias was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) and QUADAS-C. The imaging modalities were compared with Likert scores of lung nodules and radiation dose exposure (measured in mGy and mS). Certainty of evidence was evaluated using Grading of Recommendations, Assessment, Development, and Evaluations (GRADE). Results: Thirteen studies were included with 718 patients and 362 lung nodules. PC-CT had a significantly higher image quality score of + 0.45 (CI = 0.12 to 0.79) than the EID-CT. Furthermore, 54.0 % (CI = 21.2 % to 86.8 %) of nodules were qualitatively identified as having better image quality in PC-CT than in EID-CT, while 1.9 % (CI = 0 % to 4.9 %) had lower image quality. In terms of radiation dose exposure, PC-CT showed a 30.4 % (CI = 19.1 % to 41.7 %) reduction in radiation dose exposure compared to EID-CT. Conclusion: The as low as reasonably achievable (ALARA) principle emphasizes minimizing ionizing radiation exposure whenever possible. PC-CT has become an up-and-coming imaging method for chest, providing enhanced spatial resolution and less radiation exposure. Integrating PC-CT into daily medical practice and lung cancer screening may enhance the visibility of lung nodules and improve diagnostic accuracy. © 2024