{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T23:11:29Z","timestamp":1790032289411,"version":"4.0.1"},"reference-count":38,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rofo"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Photon-counting CT (PCCT) and spectral shaping enable new approaches in pediatric imaging, but the effects of clinically implemented tin-filtered pediatric chest protocols on radiation dose and image noise across image quality levels (IQLs) remain insufficiently characterized. This study compared a clinical Sn100 kVp ultra-high resolution (UHR) protocol with a non-tin-filtered 90 kVp standard-resolution protocol using anthropomorphic pediatric phantoms.<\/jats:p>\n                  <jats:p>Three pediatric phantoms (1, 5, and 10 years) were scanned on a commercial PCCT system across IQLs 1\u2013300 using the clinical Sn100 kVp UHR and non-tin-filtered 90 kVp standard-resolution protocols. Radiation dose and ROI-based image noise in lung parenchyma and bone were recorded.<\/jats:p>\n                  <jats:p>The Sn100 kVp UHR protocol showed lower lung-parenchymal noise across all phantom sizes and IQLs and generally lower bone noise. In the ultra-low-dose range (IQL 1\u201310), lung-parenchymal noise reductions ranged from 31% to 52% and bone-noise reductions reached 58%. Across most IQLs, the Sn100 kVp UHR protocol was associated with higher radiation dose. At high IQLs, dose plateaus occurred at approximately IQL 150 and 100 in the 5- and 10-year-old phantoms, followed by dose crossovers at approximately IQL 220 and 150, respectively. At very low IQLs, the Sn100 kVp UHR protocol showed a dose advantage up to IQL 5, 4, and 3 in the 1-, 5-, and 10-year-old phantoms, respectively.<\/jats:p>\n                  <jats:p>The Sn100 kVp UHR protocol was associated with lower image noise but was not universally dose-saving compared with the non-tin-filtered 90 kVp standard-resolution protocol. In addition, the observed dose behavior was influenced not only by spectral shaping but also by detector readout mode and protocol-specific technical constraints. These findings may support future pediatric chest PCCT protocol optimization.<\/jats:p>","DOI":"10.1055\/a-2935-4084","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T22:45:33Z","timestamp":1790030733000},"source":"Crossref","is-referenced-by-count":0,"title":["Pediatric Chest Photon-counting CT: Dose and Noise Behavior of Clinical Sn100 kVp and 90 kVp Protocols across Image Quality Levels \u2013 a Phantom Study"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7850-3589","authenticated-orcid":false,"given":"Laura Valentina","family":"Kl\u00fcner","sequence":"additional","affiliation":[{"name":"University Hospital Essen, Germany","place":["Essen"],"department":["Institute of Diagnostic and Interventional Radiology and Neuroradiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2997-0740","authenticated-orcid":false,"given":"Sebastian","family":"Zensen","sequence":"additional","affiliation":[{"name":"University Hospital Essen, Germany","place":["Essen"],"department":["Institute of Diagnostic and Interventional Radiology and Neuroradiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Peuster","sequence":"additional","affiliation":[{"name":"University of Duisburg-Essen, Germany","place":["Essen"],"department":["Faculty of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Ebenau","sequence":"additional","affiliation":[{"name":"University Hospital Essen, Germany","place":["Essen"],"department":["Department of Radiotherapy, West German Cancer Center"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9585-9787","authenticated-orcid":false,"given":"Denise","family":"Bos","sequence":"additional","affiliation":[{"name":"University Hospital Essen, Germany","place":["Essen"],"department":["Institute of Diagnostic and Interventional Radiology and Neuroradiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raya","family":"Ocker-Serger","sequence":"additional","affiliation":[{"name":"University Hospital Essen, Germany","place":["Essen"],"department":["Institute of Diagnostic and Interventional Radiology and Neuroradiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yannick Laurent","family":"Thal","sequence":"additional","affiliation":[{"name":"University Hospital Essen, Germany","place":["Essen"],"department":["Institute of Diagnostic and Interventional Radiology and Neuroradiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Salh\u00f6fer","sequence":"additional","affiliation":[{"name":"University Hospital Essen, Germany","place":["Essen"],"department":["Institute of Diagnostic and Interventional Radiology and Neuroradiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Stehling","sequence":"additional","affiliation":[{"name":"University Hospital Essen, Germany","place":["Essen"],"department":["Pediatric Pulmonology and Sleep Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Bernard","sequence":"additional","affiliation":[{"name":"University Hospital Essen, Germany","place":["Essen"],"department":["Pediatric Pulmonology and Sleep Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"B\u00fcscher","sequence":"additional","affiliation":[{"name":"Ruhrlandklinik, Germany","place":["Essen"],"department":["Department of Pulmonary Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Welsner","sequence":"additional","affiliation":[{"name":"Ruhrlandklinik, Germany","place":["Essen"],"department":["Department of Pulmonary Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lale","family":"Umutlu","sequence":"additional","affiliation":[{"name":"University Hospital Essen, Germany","place":["Essen"],"department":["Institute of Diagnostic and Interventional Radiology and Neuroradiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Forsting","sequence":"additional","affiliation":[{"name":"University Hospital Essen, Germany","place":["Essen"],"department":["Institute of Diagnostic and Interventional Radiology and Neuroradiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Haubold","sequence":"additional","affiliation":[{"name":"University Hospital Essen, Germany","place":["Essen"],"department":["Institute of Diagnostic and Interventional Radiology and Neuroradiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7455-8590","authenticated-orcid":false,"given":"Marcel Klaus","family":"Opitz","sequence":"additional","affiliation":[{"name":"University Hospital Essen, Germany","place":["Essen"],"department":["Institute of Diagnostic and Interventional Radiology and Neuroradiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"700","DOI":"10.1001\/jamapediatrics.2013.311","article-title":"The Use of Computed Tomography in Pediatrics and the Associated Radiation Exposure 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