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Multiparametric MRI served as the reference standard. CT images were assessed for the presence of PCLs by three radiologists independently in a blinded reading. Image quality, lesion conspicuity, and diagnostic confidence were rated on a 5-point Likert scale (5\u2009=\u2009excellent). The coefficient of variation (CV) and the density difference between PCLs and visually normal pancreatic parenchyma were calculated as quantitative imaging measures. Radiation dose was assessed using CTDIvol [mGy].<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Among 106 included patients (age 62.7\u2009\u00b1\u200912.6\u00a0years; 45 [42.5%] male), 46 had MRI-confirmed cystic lesions (mean size 8.7\u2009\u00b1\u20097.4\u00a0mm; range 2\u201345\u00a0mm). Diagnostic accuracy for PCLs was significantly higher for PCD-CT vs. EID-CT (area under the curve: 0.81 vs. 0.74; <jats:italic>p<\/jats:italic>\u2009=\u20090.002; sensitivity: 76.8% vs. 59.4%). Image quality, lesion conspicuity, and diagnostic confidence were rated superior for PCD-CT vs. EID-CT (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Quantitative analyses revealed a significantly lower CV (0.19 vs. 0.24; <jats:italic>p<\/jats:italic>\u2009=\u20090.002) and a higher density difference (94.1 HU vs. 76.6 HU <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) between PCLs and visually normal pancreatic parenchyma at lower radiation doses (7.13 vs. 8.68\u00a0mGy; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) for PCD-CT vs. EID-CT.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>PCD-CT provided significantly higher diagnostic accuracy and superior image quality for the detection of PCLs compared to conventional EID-CT at lower radiation dose.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s11547-025-02015-w","type":"journal-article","created":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T01:47:17Z","timestamp":1745200037000},"page":"1064-1073","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Simple cystic lesions of the pancreas: image quality and diagnostic accuracy of photon-counting detector computed tomography"],"prefix":"10.1007","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8992-2401","authenticated-orcid":false,"given":"Stephan","family":"Rau","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Stein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Rau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Wilpert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabian","family":"Pallasch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Balazs","family":"Bogner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Faby","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabian","family":"Bamberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jakob","family":"Weiss","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,4,21]]},"reference":[{"key":"2015_CR1","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1136\/gutjnl-2016-313127","volume":"67","author":"M-L Kromrey","year":"2018","unstructured":"Kromrey M-L, B\u00fclow R, H\u00fcbner J et al (2018) Prospective study on the incidence, prevalence and 5-year pancreatic-related mortality of pancreatic cysts in a population-based study. 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