Photon-counting CT可提升放疗精准度，降低辐射剂量，助力个性化治疗。
Photon-Counting CT in Cancer Radiotherapy: Technological Advances and Clinical Benefits
- 采用能量分辨探测技术，实现更高分辨率与多能成像。
- 减少辐射剂量，改善肿瘤定位与剂量计算准确性。
- 适合追求精准放疗的临床医生与研究者参考。
光子计数计算机断层扫描（PCCT）相较于传统能量积分探测器（EID）CT系统有显著进步。本综述强调了PCCT在空间分辨率和对比度分辨率上的优势、更低的辐射剂量以及多能成像能力，有效应对放疗中的关键挑战，如精确勾画肿瘤、精准剂量计算及治疗反应监测。其增强的解剖清晰度有助于更精准地靶向肿瘤，同时减少对周围健康组织的损伤。此外，金属伪影减少（MAR）和量化成像能力优化了工作流程，支持自适应放疗和基于放射组学的个性化治疗。在近距离放疗和放射性药物治疗（RPT）中的新兴临床应用展现出良好前景，但高成本和软件集成有限仍是挑战。随着人工智能（AI）与专用放疗软件包的发展，PCCT有望大幅提升癌症放疗的精准性、安全性与疗效，成为未来临床实践的关键技术。
原文摘要 · Abstract (English)
Photon-counting computed tomography (PCCT) marks a significant advancement over conventional energy-integrating detector (EID) CT systems. This review highlights PCCT's superior spatial and contrast resolution, reduced radiation dose, and multi-energy imaging capabilities, which address key challenges in radiotherapy, such as accurate tumor delineation, precise dose calculation, and treatment response monitoring. PCCT's improved anatomical clarity enhances tumor targeting while minimizing damage to surrounding healthy tissues. Additionally, metal artifact reduction (MAR) and quantitative imaging capabilities optimize workflows, enabling adaptive radiotherapy and radiomics-driven personalized treatment. Emerging clinical applications in brachytherapy and radiopharmaceutical therapy (RPT) show promising outcomes, although challenges like high costs and limited software integration remain. With advancements in artificial intelligence (AI) and dedicated radiotherapy packages, PCCT is poised to transform precision, safety, and efficacy in cancer radiotherapy, marking it as a pivotal technology for future clinical practice.
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