{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T14:01:56Z","timestamp":1789740116519,"version":"4.0.1"},"reference-count":32,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01EB035092"],"award-info":[{"award-number":["R01EB035092"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2026,8]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Photon\u2010counting CT (PCCT) offers key advantages over energy integrating detector CT (EID\u2010CT), especially in low\u2010dose scans and imaging larger patients. As obesity rates rise, minimizing image noise is critical for diagnostic accuracy.<\/jats:p>\n <\/jats:sec>\n \n Purpose<\/jats:title>\n To evaluate the dose efficiency of cadmium\u2010zinc\u2010telluride (CZT) based PCCT compared to EID\u2010CT across phantom sizes.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A patient\u2010specific 3D\u2010printed pancreas phantom and a phantom with tissue mimicking inserts were placed in extension rings corresponding to the 50\n th<\/jats:sup>\n , 75\n th<\/jats:sup>\n , 85\n th<\/jats:sup>\n , and 95\n th<\/jats:sup>\n percentile adult waist circumferences. Phantoms were scanned on both PCCT and EID\u2010CT with CTDI\n vol<\/jats:sub>\n ranging from 0.5 to 19.4 mGy. Noise was measured in both phantoms to evaluate dose efficiency. Non\u2010Poisson noise at low doses (<2 mGy) was quantified using root mean square error from linear fits of the noise\u2010dose relationship. Potential dose reduction was then assessed by matching noise levels between scanners across phantom sizes.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n PCCT demonstrated reduced noise compared to EID\u2010CT across all phantom sizes and doses with average noise reductions of 22%, 23%, 25%, and 28% for the 50\n th<\/jats:sup>\n , 75\n th<\/jats:sup>\n , 85\n th<\/jats:sup>\n , and 95\n th<\/jats:sup>\n percentile phantoms, respectively. Noise reduction was greater at lower doses and larger phantom sizes, reaching 88 HU at 1 mGy for the 95\n th<\/jats:sup>\n percentile phantom. Non\u2010Poisson noise decreased significantly with PCCT compared to EID\u2010CT for all phantom sizes (p\u00a0<\u00a00.013). At matched noise levels, PCCT enabled potential dose reductions of 33% and 44% for the 50\n th<\/jats:sup>\n and 95\n th<\/jats:sup>\n percentile phantoms, respectively.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n PCCT exhibited superior dose efficiency compared to EID\u2010CT across a range of phantom sizes. The enhanced dose efficiency enables both noise reduction and potential dose reduction for the imaging of obese patients and low\u2010dose imaging applications. Further evaluation with task\u2010based image quality metrics remains necessary before clinical implementation of dose reduction.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/acm2.70720","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T15:08:21Z","timestamp":1785164901000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Obese patient imaging: Potential dose reduction with photon\u2010counting CT"],"prefix":"10.1002","volume":"27","author":[{"given":"Leening P.","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Radiology University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Mei","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shobhit","family":"Sharma","sequence":"additional","affiliation":[{"name":"Canon Medical Research USA Vernon Hills Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Ross","sequence":"additional","affiliation":[{"name":"Canon Medical Research USA Vernon Hills Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra S.","family":"Halliburton","sequence":"additional","affiliation":[{"name":"Canon Healthcare USA Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Thompson","sequence":"additional","affiliation":[{"name":"Canon Healthcare USA Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naruomi","family":"Akino","sequence":"additional","affiliation":[{"name":"Canon Medical Systems Corporation Otawara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali H.","family":"Dhanaliwala","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonid","family":"Roshkovan","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harold I.","family":"Litt","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Pennsylvania Philadelphia Pennsylvania USA"},{"name":"Cleveland Clinic Foundation Weston Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter B.","family":"No\u00ebl","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)02750-2"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40273-014-0243-x"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021423"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2003.08.012"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.344135128"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20170931"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A5768"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rcl.2008.10.006"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.2021200196"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-021-08438-z"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330\u2010023\u201009545\u20109"},{"key":"e_1_2_10_13_1","doi-asserted-by":"crossref","unstructured":"WangX ZamyatinA ShiD.Dose reduction potential with photon counting computed tomography.Proceedings of the Medical Imaging 2012: Physics of Medical Imaging. 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