Giuseppe Tremamunno, Akos Varga-Szemes, U Joseph Schoepf, Dmitrij Kravchenko, Muhammad Taha Hagar, Chiara Gnasso, Emese Zsarnóczay, Jim O'Doherty, Damiano Caruso, Andrea Laghi, Bálint Szilveszter, Borbála Vattay, Pál Maurovich-Horvat, Ismail Mikdat Kabakus, Pal Spruill Suranyi, Tilman Emrich, Milan Vecsey-Nagy
{"title":"冠状动脉疾病负担的半定量指标：超高分辨率光子计数检测器CT和能量积分检测器CT的个体内比较","authors":"Giuseppe Tremamunno, Akos Varga-Szemes, U Joseph Schoepf, Dmitrij Kravchenko, Muhammad Taha Hagar, Chiara Gnasso, Emese Zsarnóczay, Jim O'Doherty, Damiano Caruso, Andrea Laghi, Bálint Szilveszter, Borbála Vattay, Pál Maurovich-Horvat, Ismail Mikdat Kabakus, Pal Spruill Suranyi, Tilman Emrich, Milan Vecsey-Nagy","doi":"10.1016/j.jcct.2025.04.012","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Quantitative coronary stenosis and plaque volumes have demonstrated intra-individual differences between ultrahigh-resolution (UHR) photon-counting detector (PCD)-CT and energy-integrating detector (EID)-CT. This study aimed to assess the impact of UHR PCD-CT on semiquantitative scores of coronary artery disease (CAD) burden compared with EID-CT.</p><p><strong>Methods: </strong>Patients undergoing coronary CT angiography (CCTA) on an EID-CT system for stable chest pain or pre-transcatheter aortic valve replacement evaluation were prospectively enrolled for UHR PCD-CT scan within 30 days. Both datasets were visually evaluated using five established semiquantitative scores: Segment Involvement Score (SIS), Segment Stenosis Score (SSS), Multivessel Aggregate Stenosis Score (MVAS), CCTA-adapted Leaman score (CT-LeSc), and Coronary Artery Disease Reporting and Data System (CAD-RADS). Additionally, the total number of detected plaques and high-risk features were reported (positive remodeling, spotty calcification, low-attenuation, and napkin-ring sign).</p><p><strong>Results: </strong>The cohort comprised 46 patients (37 men, 68.4 ± 6.9 years). When assessing stenosis severity, PCD-CT showed lower SSS (3.5 [1.3-5.0] vs 6.5 [3.0-9.8], p < 0.001), MVAS (5.5 [4.0-7.0] vs 7.0 [5.0-9.0], p < 0.001), and CT-LeSc (10.4 [8.5-13.9] vs 11.2 [8.8-15.4], p = 0.032). Furthermore, 52 % (24/46) of patients were reclassified to a lower CAD-RADS category compared to EID-CT. In terms of CAD extent, PCD-CT demonstrated higher SIS (8.0 [6.0-9.0] vs 7.0 [6.0-8.8], p = 0.018) and plaque count (9.0 [7.0-13.8] vs 7.0 [7.0-9.8] p < 0.001). Positive remodeling was less frequent in PCD-CT datasets (2.0 [1.0-4.3] vs 1.0 [0.0-3.0], p = 0.012), with no significant differences in other high-risk features.</p><p><strong>Conclusion: </strong>The use of UHR PCD-CT detects less severe, but more extensive CAD compared to EID-CT. The effect of such CCTA-based differences on individual risk stratification needs further investigation.</p>","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Semiquantitative metrics of coronary artery disease burden: Intra-individual comparison between ultrahigh-resolution photon-counting detector CT and energy-integrating detector CT.\",\"authors\":\"Giuseppe Tremamunno, Akos Varga-Szemes, U Joseph Schoepf, Dmitrij Kravchenko, Muhammad Taha Hagar, Chiara Gnasso, Emese Zsarnóczay, Jim O'Doherty, Damiano Caruso, Andrea Laghi, Bálint Szilveszter, Borbála Vattay, Pál Maurovich-Horvat, Ismail Mikdat Kabakus, Pal Spruill Suranyi, Tilman Emrich, Milan Vecsey-Nagy\",\"doi\":\"10.1016/j.jcct.2025.04.012\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Quantitative coronary stenosis and plaque volumes have demonstrated intra-individual differences between ultrahigh-resolution (UHR) photon-counting detector (PCD)-CT and energy-integrating detector (EID)-CT. This study aimed to assess the impact of UHR PCD-CT on semiquantitative scores of coronary artery disease (CAD) burden compared with EID-CT.</p><p><strong>Methods: </strong>Patients undergoing coronary CT angiography (CCTA) on an EID-CT system for stable chest pain or pre-transcatheter aortic valve replacement evaluation were prospectively enrolled for UHR PCD-CT scan within 30 days. Both datasets were visually evaluated using five established semiquantitative scores: Segment Involvement Score (SIS), Segment Stenosis Score (SSS), Multivessel Aggregate Stenosis Score (MVAS), CCTA-adapted Leaman score (CT-LeSc), and Coronary Artery Disease Reporting and Data System (CAD-RADS). Additionally, the total number of detected plaques and high-risk features were reported (positive remodeling, spotty calcification, low-attenuation, and napkin-ring sign).</p><p><strong>Results: </strong>The cohort comprised 46 patients (37 men, 68.4 ± 6.9 years). When assessing stenosis severity, PCD-CT showed lower SSS (3.5 [1.3-5.0] vs 6.5 [3.0-9.8], p < 0.001), MVAS (5.5 [4.0-7.0] vs 7.0 [5.0-9.0], p < 0.001), and CT-LeSc (10.4 [8.5-13.9] vs 11.2 [8.8-15.4], p = 0.032). Furthermore, 52 % (24/46) of patients were reclassified to a lower CAD-RADS category compared to EID-CT. In terms of CAD extent, PCD-CT demonstrated higher SIS (8.0 [6.0-9.0] vs 7.0 [6.0-8.8], p = 0.018) and plaque count (9.0 [7.0-13.8] vs 7.0 [7.0-9.8] p < 0.001). Positive remodeling was less frequent in PCD-CT datasets (2.0 [1.0-4.3] vs 1.0 [0.0-3.0], p = 0.012), with no significant differences in other high-risk features.</p><p><strong>Conclusion: </strong>The use of UHR PCD-CT detects less severe, but more extensive CAD compared to EID-CT. The effect of such CCTA-based differences on individual risk stratification needs further investigation.</p>\",\"PeriodicalId\":94071,\"journal\":{\"name\":\"Journal of cardiovascular computed tomography\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-05-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of cardiovascular computed tomography\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jcct.2025.04.012\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of cardiovascular computed tomography","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.jcct.2025.04.012","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Semiquantitative metrics of coronary artery disease burden: Intra-individual comparison between ultrahigh-resolution photon-counting detector CT and energy-integrating detector CT.
Background: Quantitative coronary stenosis and plaque volumes have demonstrated intra-individual differences between ultrahigh-resolution (UHR) photon-counting detector (PCD)-CT and energy-integrating detector (EID)-CT. This study aimed to assess the impact of UHR PCD-CT on semiquantitative scores of coronary artery disease (CAD) burden compared with EID-CT.
Methods: Patients undergoing coronary CT angiography (CCTA) on an EID-CT system for stable chest pain or pre-transcatheter aortic valve replacement evaluation were prospectively enrolled for UHR PCD-CT scan within 30 days. Both datasets were visually evaluated using five established semiquantitative scores: Segment Involvement Score (SIS), Segment Stenosis Score (SSS), Multivessel Aggregate Stenosis Score (MVAS), CCTA-adapted Leaman score (CT-LeSc), and Coronary Artery Disease Reporting and Data System (CAD-RADS). Additionally, the total number of detected plaques and high-risk features were reported (positive remodeling, spotty calcification, low-attenuation, and napkin-ring sign).
Results: The cohort comprised 46 patients (37 men, 68.4 ± 6.9 years). When assessing stenosis severity, PCD-CT showed lower SSS (3.5 [1.3-5.0] vs 6.5 [3.0-9.8], p < 0.001), MVAS (5.5 [4.0-7.0] vs 7.0 [5.0-9.0], p < 0.001), and CT-LeSc (10.4 [8.5-13.9] vs 11.2 [8.8-15.4], p = 0.032). Furthermore, 52 % (24/46) of patients were reclassified to a lower CAD-RADS category compared to EID-CT. In terms of CAD extent, PCD-CT demonstrated higher SIS (8.0 [6.0-9.0] vs 7.0 [6.0-8.8], p = 0.018) and plaque count (9.0 [7.0-13.8] vs 7.0 [7.0-9.8] p < 0.001). Positive remodeling was less frequent in PCD-CT datasets (2.0 [1.0-4.3] vs 1.0 [0.0-3.0], p = 0.012), with no significant differences in other high-risk features.
Conclusion: The use of UHR PCD-CT detects less severe, but more extensive CAD compared to EID-CT. The effect of such CCTA-based differences on individual risk stratification needs further investigation.
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