Photon-Counting CT Takes Center Stage at RSNA 2025

Photon-counting CT (PCCT) is commanding significant attention at RSNA 2025, as major manufacturers debut second-generation systems and early adopters report stronger clinical performance across specialties. The technology is emerging as one of the meeting’s defining innovations, signaling a shift toward broader clinical integration.

Vendors Advance Second-Generation Designs

Siemens Healthineers is showcasing enhancements to its NAEOTOM Alpha, including higher count-rate detectors and expanded spectral algorithms. GE HealthCare is highlighting the latest updates to its Revolution Apex PC, emphasizing improved charge-sharing correction and noise-reduction circuitry. Canon Medical is demonstrating progress with its Spectral Detector PCCT research platform, while Philips is previewing next-generation photon-counting development integrated with AI-based reconstruction tools.

Technical Gains Improve Resolution and Spectral Fidelity

Technical sessions focus on detector physics, with energy-resolving detectors now delivering better electronic noise rejection, reduced pulse pile-up, and stable energy-bin separation at high photon flux. Researchers present data showing spatial resolution improvements in the 0.2–0.4 mm range, enhanced edge definition, and more robust material decomposition using multi-bin spectral information.

Clinical Impact Broadens Across Specialties

Clinicians report clearer visualization of non-calcified coronary plaque, more confident assessment of vulnerable lesions, and reduced blooming artifacts around stents. Oncologic presentations highlight improved lesion conspicuity and more precise quantification of iodine uptake. MSK radiologists note unprecedented visualization of trabecular bone and cartilage interfaces. Several pediatric centers are reporting dose reductions exceeding 30–40%, supported by PCCT’s higher quantum efficiency.

Workflow Integration Gains Momentum

Workflow efficiency is a recurring theme. Vendors are introducing automation tools for spectral protocol selection, while institutions share strategies for integrating spectral maps and quantitative biomarkers directly into PACS. Early adopters emphasize the importance of standardized workflows and cross-disciplinary training as spectral data becomes more widely incorporated into routine practice.

Photon-counting CT is no longer a future promise at RSNA 2025—it is emerging as the next major evolution in CT imaging, with maturing technology, expanding clinical evidence, and increasing operational readiness positioning it for broader adoption.