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Objectives <p>To systematically review and perform a meta-analysis comparing the effects of PCD-CT versus EID-CT on image quality (sharpness) and radiation dose (CTDIvol) in patients with bone lesions due to multiple myeloma&#xa0;(MM).</p> Methods <p>A comprehensive search of PubMed, Embase, Scopus, and Cochrane Central was conducted from inception to October 2025. Studies comparing PCD-CT and EID-CT in MM patients were included. Methodological quality was assessed using ROBINS-I, and the certainty of evidence was assessed using GRADE.</p> Results <p>A total of 41 studies were identified that matched our search criteria. After duplicate removal and screening, five studies (<i>n</i> = 170 patients) were included in the systematic review, with four contributing to the meta-analysis. PCD-CT showed a significant pooled mean difference in image sharpness (mean difference, + 0.99 points; 95% CI, 0.62–1.37; <i>p</i> &lt; 0.001). PCD-CT also demonstrated a reduction in radiation dose (mean difference, −4.95 milligrays; 95% CI, −8.39 to −1.50; <i>p</i> = 0.005). Trial sequential analysis (TSA) confirmed stability of pooled estimates, with conclusive evidence for image sharpness improvement, and suggestive yet incomplete evidence for radiation dose reduction.</p> Conclusion <p>Compared to EID-CT in MM, PCD-CT significantly improves subjective image sharpness as supported by trial sequential analysis. Conventional meta-analysis suggested a reduction in radiation dose with PCD-CT; however, trial sequential analysis indicated that the cumulative evidence remains inconclusive. Further large-scale studies are suggested to confirm the magnitude of the radiation dose reduction benefit.</p>

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Photon-counting detector computed tomography (PCD-CT) in multiple myeloma: a systematic review and trial sequential meta-analysis on image quality and radiation dose

  • 期刊论文

  • 发表日期：

    2026年5月27日

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  • Victor Arthur Ohannesian,
  • Bruna Colabono Taneja,
  • Adham do Amaral e Castro,
  • Frederico Celestino Miranda,
  • Carlos Henrique Tudino,
  • Flavio Duarte Silva,
  • Atul Kumar Taneja

摘要

Objectives

To systematically review and perform a meta-analysis comparing the effects of PCD-CT versus EID-CT on image quality (sharpness) and radiation dose (CTDIvol) in patients with bone lesions due to multiple myeloma (MM).

Methods

A comprehensive search of PubMed, Embase, Scopus, and Cochrane Central was conducted from inception to October 2025. Studies comparing PCD-CT and EID-CT in MM patients were included. Methodological quality was assessed using ROBINS-I, and the certainty of evidence was assessed using GRADE.

Results

A total of 41 studies were identified that matched our search criteria. After duplicate removal and screening, five studies (n = 170 patients) were included in the systematic review, with four contributing to the meta-analysis. PCD-CT showed a significant pooled mean difference in image sharpness (mean difference, + 0.99 points; 95% CI, 0.62–1.37; p < 0.001). PCD-CT also demonstrated a reduction in radiation dose (mean difference, −4.95 milligrays; 95% CI, −8.39 to −1.50; p = 0.005). Trial sequential analysis (TSA) confirmed stability of pooled estimates, with conclusive evidence for image sharpness improvement, and suggestive yet incomplete evidence for radiation dose reduction.

Conclusion

Compared to EID-CT in MM, PCD-CT significantly improves subjective image sharpness as supported by trial sequential analysis. Conventional meta-analysis suggested a reduction in radiation dose with PCD-CT; however, trial sequential analysis indicated that the cumulative evidence remains inconclusive. Further large-scale studies are suggested to confirm the magnitude of the radiation dose reduction benefit.