The application of quantum-counting detectors in clinical Computed Tomography (CT) is challenged by extreme X-ray fluxes provided by modern high-power X-ray tubes. Scanning of small objects or sub-optimal patient positioning may lead to situations where those fluxes impinge on the detector without attenuation. Even in operation modes optimized for high-rate applications, with small pixels and high bias voltage, CdTe/CdZnTe detectors deliver pulses in the range of several nanoseconds. This can result in severe pulse pile-up causing detector paralysis and ambiguous detector signals. To overcome this problem we introduce the pile-up trigger, a novel method that provides unambiguous detector signals in rate regimes where classical rising-edge counters run into count-rate paralysis. We present detailed CT image simulations assuming ideal sensor material not suffering from polarization effects at high X-ray fluxes. This way we demonstrate the general feasibility of the pile-up trigger method and quantify resulting imaging properties such as contrasts, image noise and dual-energy performance in the high-flux regime of clinical CT devices.
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