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Updated: Jan 10, 2026

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
04:40

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans

Published on: August 28, 2018

15.9K

Ultra-high resolution photon-counting detector coronary CT angiography: diagnostic accuracy in patients with high

Tristan T Demmert1, Konstantin Klambauer1, Lukas J Moser1

  • 1Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.

European Radiology
|November 20, 2025
PubMed

Insights

Ultra-high resolution coronary CT angiography using photon-counting detector CT accurately detects coronary stenoses in patients with severe calcification. This advanced imaging technique minimizes artifacts, offering high diagnostic performance and potentially reducing the need for invasive procedures.

Area of Science:

  • Cardiovascular Imaging
  • Radiology
  • Medical Diagnostics

Background:

  • Severe coronary artery calcification causes blooming artifacts in conventional coronary CT angiography (CCTA), potentially compromising diagnostic accuracy.
  • Ultra-high resolution (UHR) photon-counting detector CT (PCD-CT) technology is designed to mitigate these blooming artifacts.

Purpose of the Study:

  • To evaluate the diagnostic performance of UHR CCTA with PCD-CT for detecting coronary stenoses in patients with high coronary calcium burden.
  • To compare the diagnostic accuracy of UHR CCTA with PCD-CT against invasive coronary angiography (ICA).

Main Methods:

  • A single-center study included patients with Agatston scores > 600 who underwent both ICA and UHR PCD-CT angiography.
  • Two blinded readers assessed coronary arteries for diameter stenosis severity (>50%, >70%).
  • Diagnostic accuracy, sensitivity, and specificity were calculated using ICA as the reference standard, with subgroup analyses based on Agatston score categories.

Main Results:

  • 62 patients (median Agatston score 2423) were analyzed.
  • UHR CCTA with PCD-CT demonstrated high diagnostic accuracy and strong agreement with ICA (Cohen's kappa 0.71-1.00) across all Agatston score groups.
  • In patients with Agatston scores > 3000, diagnostic performance for detecting >50% and >70% stenosis remained high (sensitivity 88-100%, specificity 83-100%).

Conclusions:

  • UHR CCTA utilizing PCD-CT offers high diagnostic performance for detecting coronary stenoses, even in the presence of extensive coronary calcification.
  • This technology can accurately identify stenoses in heavily calcified vessels, potentially serving as a noninvasive alternative to ICA and reducing unnecessary invasive procedures.
Abstract

Keywords:
Agatston scoreCCTACalcificationCoronaryICA

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