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Coronary CT Angiography with Photon-counting CT: First-In-Human Results.
Salim A Si-Mohamed1, Sara Boccalini1, Hugo Lacombe1
1From the University Lyon, INSA-Lyon, University Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, Villeurbanne, France (S.A.S.M., S.B., H.L., A.D., M. Varasteh, P.A.R., V.T.L., L.B., P.C.D.); Departments of Radiology (S.A.S.M., S.B., L.B., P.C.D.) and Cardiology (T.B., E.B., G.R., G.F., C.B.), Louis Pradel Hospital, Hospices Civils de Lyon, Bron, France; Department of Radiology, Faculty of Medicine, Zagazig University, Egypt (R.D.); Philips Healthcare, Suresnes, France (M Villien, P.C.); Philips Healthcare, Haifa, Israel (Y.Y., E.L.); Philips Healthcare, Hamburg, Germany (K.E.); Public Health Center, Department of Biostatistics and Bioinformatics, Hospices Civils de Lyon, Lyon, France (B.R.); Department of Biometrics and Evolutionary Biology Laboratory, Biostatistics-Health Team, CNRS, UMR 5558, Villeurbanne, France (B.R.); and Department of Medical Imaging, CHU Nimes, University Montpellier, Nimes Medical Imaging Group, EA 2992, Montpellier, France (J.G.).
Photon-counting CT (PCCT) significantly enhances coronary CT angiography (CCTA) image quality and diagnostic confidence compared to conventional dual-layer CT. This advancement offers superior visualization of coronary arteries and plaques.
Area of Science:
- Medical Imaging
- Radiology
- Cardiovascular Imaging
Background:
- Photon-counting CT (PCCT) offers potential advantages in spatial resolution, soft-tissue contrast, and dose efficiency for coronary CT angiography (CCTA).
- Conventional energy-integrating detector (EID) dual-layer CT (DLCT) is the current standard for CCTA acquisition.
Purpose of the Study:
- To compare the image quality and diagnostic confidence of CCTA acquired with a prototype PCCT system versus an EID DLCT system.
- To assess the performance of PCCT in visualizing coronary calcifications, stents, and noncalcified plaques.
Main Methods:
- Prospective study involving CCTA acquisition on both PCCT and EID DLCT systems in participants with coronary artery disease.
- Independent, blinded analysis by three cardiac radiologists using a five-point quality scale.
- Phantom study to evaluate lesion detectability index.
Main Results:
- PCCT demonstrated significantly higher scores for overall image quality (median 5 vs. 4) and diagnostic confidence (median 5 vs. 4) compared to EID DLCT.
- PCCT achieved superior visualization of calcifications (100% improvement), stents (92% improvement), and noncalcified plaques (45% improvement).
- Phantom studies showed 2.3-fold higher lumen and 2.9-fold higher noncalcified plaque detectability with PCCT.
Conclusions:
- Coronary CT angiography with PCCT provides improved image quality and diagnostic confidence over EID DLCT.
- PCCT represents a significant advancement for CCTA, enabling more confident diagnosis and characterization of coronary artery disease.
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