The dawn of photon-counting CT and its clinical revolution in China
China's domestic PHOTON-COUNTING CT era begins
In a clear signal of a major shift in the global medical device landscape, China's National Medical Products Administration (NMPA) granted market approval to a domestically engineered photon-counting computed tomography (PCCT) system in August 2025. The approval for United Imaging Healthcare’s uCT Ultima, a flagship project backed by national funding, marks a pivotal moment for the nation's high-end diagnostic equipment sector.1 This milestone ends the market exclusivity previously held by the Siemens Healthineers NAEOTOM Alpha, which, since its NMPA approval in late 2023, was the only PCCT system commercially available in China. The arrival of the state-of-the-art domestic system is poised to introduce intense competition to the ultra-high-end imaging market, potentially expanding access for Chinese hospitals and reducing costs. More broadly, this event signals China’s transition from a technology adopter to a key innovator.
Immediately following the approvals, the new systems were deployed for clinical research and validation. United Imaging's uCT Ultima, for instance, was installed at two of China’s most prestigious academic medical centers: Zhongshan Hospital, affiliated with Fudan University, and Ruijin Hospital, affiliated with the Shanghai Jiao Tong University School of Medicine (Figure 1A). This rapid deployment initiates a crucial phase of clinical validation to integrate PCCT into daily practice, establish new standards of care, and solidify the technology's foundation in China.
Early clinical validation in shanghai's medical centers
The theoretical advantages of PCCT are well documented—ultra-high resolution, superior low-dose performance, and inherent spectral imaging capabilities—but the transition to clinical practice requires rigorous, real-world validation. The first clinical data from China's domestic PCCT deployments are now emerging, compellingly validating the technology's transformative potential. Prospective studies at clinical sites are providing the first concrete performance metrics for these new systems.
A key feature of PCCT systems like the uCT Ultima is a detector design that enables a dramatic improvement in granularity, allowing for the visualization of previously indistinct anatomical structures. This capability is being validated in clinical trials comparing the new PCCT systems against high-end conventional energy-integrating CT (EICT) systems, specifically the uCT 960+.
In cardiovascular imaging, this enhanced resolution provides leading performance (Figure 1B). For cardiac plaques, the uCT Ultima precisely delineates the compositional boundaries of mixed plaques. For chronic total occlusion (CTO), it depicts minute perilesional neovascular networks (approximately 0.3–0.5 mm in diameter). Furthermore, the system sharply visualizes coronary stent struts and luminal contours, mitigating the metallic blooming artifacts common in EICT, and robustly supports coronary intervention evaluation.
The system also excels in anatomically complex regions (Figure 1B). In otologic imaging, it delivers superior delineation of the complete ossicular chain and cochlear structures. In ophthalmology, its high-definition imaging resolves the visualization bottleneck at the choroid-sclera interface, often blurred by partial volume effects. For pulmonary applications, PCCT produces clearer images than EICT, with superior depiction of small airways and vascular bundles. In musculoskeletal imaging, it clearly delineates cortical continuity and minute bone fragments in subtle fractures. This boosts diagnostic confidence for both initial and healing assessments.
