{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T20:04:37Z","timestamp":1782331477947,"version":"3.54.5"},"reference-count":30,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: There is an increasing need for cross-sectional imaging in pediatric patients with congenital heart disease. This patient group is highly sensitive to ionizing radiation. The purpose of this article was to evaluate differences in radiation dose and image quality between a first-generation photon-counting (PC)-CT system and a 256-slice single-source energy-integrating detector (EID)-CT in these patients. Methods: We retrospectively assessed effective dose, CT dose index-volume (CTDIvol), dose length product (DLP), and image quality of all prospectively electrocardiography-gated CTs of the thorax in all patients &lt; 18 years of age examined between February 2021 and August 2024 (n = 43). Two independent observers subjectively scored image quality, vascular contrast, and noise on a 5-point Likert scale. In addition, we assessed the signal-to-noise-ratio (SNR) and contrast-to-noise-ratio (CNR) quantitatively. Results: All dose parameters were significantly lower in the PC-CT (n = 27) versus the EID-CT (n = 16) group (mean effective dose: 0.8 \u00b1 0.64 versus 2.2 \u00b1 0.88 mSv, p &lt; 0.001; mean CTDIvol: 1.22 \u00b1 0.96 versus 4.8 \u00b1 1.08 mGy, p &lt; 0.001; mean DLP: 30.7 \u00b1 31.9 versus 73.7 \u00b1 50.7 mGy*cm, p &lt; 0.001). Overall subjective image quality and contrast were rated higher in the PC-CT group (p = 0.046 and &lt; 0.001, respectively). Quantitative CNR was significantly higher in the PC-CT group (mean 39.1 \u00b1 12.9 versus 26.2 \u00b1 10.8, p = 0.002). Conclusions: PC-CT enables high-quality examinations for the evaluation of congenital heart disease with a highly significant dose reduction compared with a 256-slice single-source EID-CT.<\/jats:p>","DOI":"10.3390\/diagnostics16050735","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T15:22:21Z","timestamp":1772551341000},"page":"735","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Photon-Counting CT Enables Higher Image Quality at a Lower Radiation Dose Compared with a 256-Slice Energy-Integrating Detector CT in Pediatric Patients with Congenital Heart Disease"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0396-8362","authenticated-orcid":false,"given":"Andr\u00e9","family":"Lollert","sequence":"first","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Section of Pediatric Radiology, Medical Center of the Johannes Gutenberg-University, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Souschek","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Section of Pediatric Radiology, Medical Center of the Johannes Gutenberg-University, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6576-7072","authenticated-orcid":false,"given":"Tariq","family":"Abu-Tair","sequence":"additional","affiliation":[{"name":"Center for Diseases in Childhood and Adolescence, Division of Pediatric Cardiology and Congenital Heart Diseases, Medical Center of the Johannes Gutenberg-University, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Dette","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Medical Center of the Johannes Gutenberg-University, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0310-6236","authenticated-orcid":false,"given":"Georg Daniel","family":"Duerr","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Section of Congenital Heart Surgery, Medical Center of the Johannes Gutenberg-University, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Kampmann","sequence":"additional","affiliation":[{"name":"Center for Diseases in Childhood and Adolescence, Division of Pediatric Cardiology and Congenital Heart Diseases, Medical Center of the Johannes Gutenberg-University, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"B\u00e4uerle","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Medical Center of the Johannes Gutenberg-University, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6240-8461","authenticated-orcid":false,"given":"Gundula","family":"Staatz","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Section of Pediatric Radiology, Medical Center of the Johannes Gutenberg-University, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2716","DOI":"10.1161\/CIRCULATIONAHA.116.023544","article-title":"Trends in Congenital Heart Disease: The Next Decade","volume":"133","author":"Triedman","year":"2016","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1007\/s00246-002-9401-6","article-title":"The epidemiology of cardiovascular defects, part I: A study based on data from three large registries of congenital malformations","volume":"24","author":"Pradat","year":"2003","journal-title":"Pediatr. 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