Prospective Comparison of Ultra-high-resolution Photon-counting-detector CT Coronary Angiography versus Conventional CT.

IF 3.4 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

British Journal of Radiology Pub Date : 2025-09-05 DOI:10.1093/bjr/tqaf220

Cynthia H McCollough, Aeden Davis, Nikki Weber, Holly Kasten, Elnata Melka, Kishore Rajendran, Rickey Carter, Shuai Leng

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引用次数: 0

Abstract

Objectives: Determine differences in quantitative stenosis severity measurements for ultra-high-resolution (UHR) photon-counting-detector (PCD) coronary CT angiography (cCTA) relative to energy-integrating-detector (EID) cCTA in a large patient cohort.

Methods: Adult participants seen between November 2022 and March 2023 underwent a clinical dual-source EID-CT cCTA and a research dual-source PCD-CT cCTA on the same day. Percent diameter stenosis (PDS) was measured, and stenosis severity was assigned based on the PDS of the most severe lesion per patient to determine a coronary-artery-disease reporting and data system (CAD-RADS) score. Agreement between EID-CT and PCD-CT for PDS and CAD-RADS was determined.

Results: A total of 112 participants were enrolled, yielding 82 subjects with at least 1 stenosis at PCD-CT (mean age, 68.0 ± 10.8 years; 69.5% (57/82) males). A total of 177 paired stenoses were quantified. The percent decrease in mean PDS from PCD-CT (24.3%) to EID-CT (29.4%) was 17.3% (median difference in PDS: -5.0%, 95% CI: -5.7% to -4.0%). The assigned CAD-RADS score changed 31/82 times. In 11/31 subjects, the most severe stenosis was missed at EID-CT due to partial volume averaging of a small calcification, yet PCD clearly identified stenosis at those locations. In 20/31 subjects, the CAD-RADS score decreased at PCD-CT due to the decreased calcium blooming resulting from the improved spatial resolution.

Conclusions: UHR PCD cCTA decreases quantitative measures of stenosis severity when a stenosis is identified at EID, leading to decreases in CAD-RADS assignments.

Advances in knowledge: With its improved spatial resolution, PCD-CT identifies stenoses missed on EID-CT.

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超高分辨率光子计数检测器CT冠状动脉造影与常规CT的前瞻性比较。

目的：在一个大型患者队列中，确定超高分辨率（UHR）光子计数检测器（PCD）冠状动脉CT血管造影（cCTA）相对于能量积分检测器（EID） cCTA的定量狭窄严重程度测量的差异。方法：2022年11月至2023年3月期间的成年参与者在同一天接受了临床双源EID-CT cCTA和研究双源PCD-CT cCTA。测量直径狭窄百分比（PDS），并根据每位患者最严重病变的PDS分配狭窄严重程度，以确定冠状动脉疾病报告和数据系统（CAD-RADS）评分。确定EID-CT和PCD-CT对PDS和CAD-RADS的诊断结果一致。结果：共纳入112名受试者，其中82名患者在PCD-CT上至少有1处狭窄（平均年龄68.0±10.8岁，男性占69.5%(57/82)）。对177例配对狭窄进行量化。平均PDS从PCD-CT（24.3%）下降到EID-CT（29.4%）的百分比为17.3% （PDS的中位差：-5.0%,95% CI: -5.7%至-4.0%）。CAD-RADS评分变化31/82次。在11/31例受试者中，由于局部体积平均的小钙化，EID-CT未发现最严重的狭窄，但PCD清楚地识别出这些位置的狭窄。在20/31的受试者中，由于空间分辨率提高导致钙盛开减少，CAD-RADS评分在PCD-CT上下降。结论：当在EID时发现狭窄时，UHR PCD cCTA降低了狭窄严重程度的定量测量，导致CAD-RADS分配减少。知识的进步：通过提高空间分辨率，PCD-CT可以识别EID-CT遗漏的狭窄。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

British Journal of Radiology 医学-核医学

CiteScore

5.30

自引率

3.80%

发文量

330

审稿时长

2-4 weeks

期刊介绍： BJR is the international research journal of the British Institute of Radiology and is the oldest scientific journal in the field of radiology and related sciences. Dating back to 1896, BJR’s history is radiology’s history, and the journal has featured some landmark papers such as the first description of Computed Tomography "Computerized transverse axial tomography" by Godfrey Hounsfield in 1973. A valuable historical resource, the complete BJR archive has been digitized from 1896. Quick Facts: - 2015 Impact Factor – 1.840 - Receipt to first decision – average of 6 weeks - Acceptance to online publication – average of 3 weeks - ISSN: 0007-1285 - eISSN: 1748-880X Open Access option