Ya-Wen Lu, Kang-Ling Wang, Yu-Wei Wang, Ming-Cheng Liu, Yun-Chung Cheng, Wen-Hsien Chen, David E Newby, Michelle C Williams, Wen-Lieng Lee, Jung-Hsuan Chen
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引用次数: 0
Abstract
Background: Photon-counting detector computed tomography (PCD-CT) is an emerging technology that improves dose efficiency, image resolution, and noise performance. We aimed to compare the safety and effectiveness of the first-generation PCD-CT with a third-generation energy-integrating detector computed tomography (EID-CT) for the detection of coronary artery disease in the participants from a health check programme in Taiwan.
Methods: In this retrospective, single-centre study, we included 205 asymptomatic individuals undergoing coronary computed tomography angiography as part of their health screening: 103 with EID-CT in July 2024 and 102 with PCD-CT in January 2025. All scans were acquired using the helical mode. Radiation exposure, iodinated contrast volume, and referral outcomes were compared between those scanned with PCD-CT and with EID-CT.
Results: Baseline characteristics were generally balanced between the two groups except for height, smoking habit, and plasma lipid and glucose concentrations. The PCD-CT group had a lower radiation dose indexed by dose length product (401.0 vs. 633.6 mGy·cm and 421.5 vs. 690.0 mGy·cm for the main scan and for the total procedure, respectively; both P < 0.001) but received higher contrast volume (65.0 vs. 49.0 ml; P < 0.001), as compared with the EID-CT group. All images were of good diagnostic quality, and the rates of referral to invasive coronary angiography (3.9 vs. 4.9%) were similar between the two groups ( P > 0.999).
Conclusions: The first-generation PCD-CT, compared with a third-generation EID-CT, offered a substantial reduction in radiation exposure without additional needs for invasive cardiac catheterisation. Further studies using contrast-optimisation technologies and dose-optimisation strategies are warranted to assess diagnostic quality.
背景：光子计数检测器计算机断层扫描（PCD-CT）是一项新兴技术，可提高剂量效率、图像分辨率和噪声性能。我们的目的是比较第一代PCD-CT与第三代能量积分检测器计算机断层扫描（EID-CT）在台湾健康检查项目参与者中检测冠状动脉疾病的安全性和有效性。方法：在这项回顾性的单中心研究中，我们纳入了205名无症状患者，他们接受了冠状动脉计算机断层血管造影作为健康筛查的一部分：103名患者于2024年7月接受了EID-CT检查，102名患者于2025年1月接受了PCD-CT检查。所有扫描均采用螺旋模式。比较了PCD-CT和EID-CT扫描患者的辐射暴露、碘化造影剂体积和转诊结果。结果：除了身高、吸烟习惯、血脂和血糖浓度外，两组的基线特征基本平衡。以剂量长度积为指标，PCD-CT组放射剂量较低（主扫描和全扫描分别为401.0 vs. 633.6 mGy·cm和421.5 vs. 690.0 mGy·cm， P均为0.999）。结论：与第三代EID-CT相比，第一代PCD-CT在不需要额外的有创心导管治疗的情况下，大大减少了辐射暴露。进一步研究使用对比优化技术和剂量优化策略评估诊断质量是必要的。
期刊介绍：
Coronary Artery Disease welcomes reports of original research with a clinical emphasis, including observational studies, clinical trials, translational research, novel imaging, pharmacology and interventional approaches as well as advances in laboratory research that contribute to the understanding of coronary artery disease. Each issue of Coronary Artery Disease is divided into four areas of focus: Original Research articles, Review in Depth articles by leading experts in the field, Editorials and Images in Coronary Artery Disease. The Editorials will comment on selected original research published in each issue of Coronary Artery Disease, as well as highlight controversies in coronary artery disease understanding and management.
Submitted artcles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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