ArticleEuropean radiology2025
Ultra-high-resolution 40 keV virtual monoenergetic imaging using spectral photon-counting CT in high-risk patients for coronary stenoses.
Article in European radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- A scoping review of photon-counting detector computed tomography in cardiovascular imaging.Diagnostic and interventional radiology (Ankara, Turkey) · 2026Article
- Increasing pulmonary artery visibility and diagnostic confidence with ultra-high resolution photon-counting detector CT pulmonary angiography.European radiology · 2026Article
- Optimizing Reconstruction Parameters for Detecting Peripheral In-Stent Restenosis with Photon-Counting Detector CT: A Phantom Study.Diagnostics (Basel, Switzerland) · 2026Article
- Ultra-high spatial resolution at photon-counting computed tomography: technical insights and sustainable applications in cardiothoracic imaging.European radiology experimental · 2026Review
- Photon-counting CT-angiography in comparison to digital subtraction angiography for assessing intracranial aneurysms after coiling or clipping.Neuroradiology · 2025Article
- Trading off Iodine and Radiation Dose in Coronary Computed Tomography.Journal of cardiovascular development and disease · 2025Review
- Value of Ultrahigh-Resolution Photon-Counting Detector Computed Tomography in Cardiac Imaging.Echocardiography (Mount Kisco, N.Y.) · 2025Review
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Authors and funding
11 authors.
Funding
Abstract
objectivesTo assess the image quality of ultra-high-resolution (UHR) virtual monoenergetic images (VMIs) at 40 keV compared to 70 keV, using spectral photon-counting CT (SPCCT) and dual-layer dual-energy CT (DECT) for coronary computed tomography angiography (CCTA). METHODS AND MATERIALS: In this prospective IRB-approved study, 26 high-risk patients were included. CCTA was performed both with an SPCCT in UHR mode and with one of two DECT scanners (iQOn or CT7500) within 3 days. 40 keV and 70 keV VMIs were reconstructed for both modalities. Stenoses, blooming artefacts, and image quality were compared between all four reconstructions.
resultsTwenty-six patients (4 women [15%]) and 28 coronary stenoses (mean stenosis of 56% ± 16%) were included. 40 keV SPCCT gave an overall higher quality score (5 [5, 5]) than 70 keV SPCCT (5 [4, 5], 40 keV DECT (4 [3, 4]) and 70 keV SPCCT (4 [4, 5]), p < 0.001). Less variability in stenosis measurement was found with SPCCT between 40 keV and 70 keV (bias: -1% ± 3%, LoA: 6%) compared with DECT (-6% ± 8%, LoA 16%). 40 keV SPCCT vs 40 keV DECT showed a -3% ± 6% bias, whereas 40 keV SPCCT vs 70 keV DECT showed a -8% ± 6% bias. From 70 keV to 40 keV, blooming artefacts did not increase with SPCCT (mean +2% ± 5%, p = 0.136) whereas they increased with DECT (mean +7% ± 6%, p = 0.005).
conclusionUHR 40 keV SPCCT VMIs outperformed 40 keV and 70 keV DECT VMIs for assessing coronary artery stenoses, with no impairment compared to 70 keV SPCCT VMIs. KEY POINTS: Question Use of low virtual mono-energetic images at 40 keV using spectral dual-energy and photon-counting CT systems is not yet established for diagnosing coronary artery stenosis. Findings UHR 40 keV SPCCT enhances diagnostic accuracy in coronary artery assessment. Clinical relevance By combining spectral sensitivity with lower virtual mono-energetic imaging and ultra-high spatial resolution, SPCCT enhances coronary artery assessment, potentially leading to more accurate diagnoses and better patient outcomes in cardiovascular imaging.
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