Spectral CT in ocular tumor characterization: technological advancements, clinical dilemmas, and translational prospects

Spectral computed tomography (CT) has emerged as a transformative imaging tool offering enhanced diagnostic accuracy and therapeutic planning capabilities in ocular oncology. By leveraging advanced quantitative and qualitative imaging features, including material decomposition, effective atomic number mapping, and energy-specific imaging, spectral CT facilitates precise differentiation between benign and malignant ocular tumors, tumor localization, and therapeutic response assessment. This review highlights its potential advantages of spectral CT over conventional CT, and discusses challenges such as radiation dose optimization, image quality refinement, and limited clinical validation. Future directions include integrating spectral CT with artificial intelligence and multi-modal imaging approaches to maximize clinical value and streamline applications in routine ocular oncology practice.