Photon Counting Detector Computed Tomography: A New Frontier of Myeloma Bone Disease Evaluation.

Photon counting detector (PCD) computed tomography (CT) is a paradigm-shifting innovation in CT imaging which was recently granted approval for clinical use by the US Food and Drug Administration. PCD-CT allows the generation of multi-energy images with increased contrast and scanning speed or ultra-high spatial resolution (UHR) images with lower radiation doses, compared to the currently used energy integrating detector (EID) CT. Since the recognition of bone disease related to multiple myeloma is important for the diagnosis and management of patients, the advent of PCD-CT heralds a new era in superior diagnostic evaluation of myeloma bone disease. In a first-in-human pilot study, patients with multiple myeloma were imaged with UHR-PCD-CT to validate and establish the utility of this technology in routine imaging and clinical care. We describe 2 cases from that cohort to highlight the superior imaging performance and diagnostic potential of PCD-CT for multiple myeloma compared to clinical standard EID-CT. We also discuss how the advanced imaging capabilities from PCD-CT enhances clinical diagnostics to improve care and overall outcomes for patients.