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

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

doi:10.1007/s00256-026-05242-y

PubMed · 42204008

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

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

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Abstract

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.

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Humans Multiple Myeloma Photons Radiation Dosage Tomography, X-Ray Computed Bone disease Cancer screening Multiple myeloma PCD-CT Photon counting CT Plasma cell dyscrasia Journal Article Systematic Review Meta-Analysis

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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. 2026-05-27. Photon-counting detector computed tomography (PCD-CT) in multiple myeloma: a systematic review and trial sequential meta-analysis on image quality and radiation dose.. https://doi.org/10.1007/s00256-026-05242-y

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