ArticleEuropean radiology2026
Ultra-high resolution photon-counting detector coronary CT angiography: diagnostic accuracy in patients with high Agatston scores.
Article in European radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
5 citing papers in PubMed.
- Photon counting detector CT contrast agent-reduced transcatheter aortic valve reconstruction planning: a comparative study.European radiology · 2026Article
- How to Individualize Coronary Assessment and Revascularization in Severe AS Patients Undergoing TAVI in the Era of Lifetime Management?Journal of clinical medicine · 2026Review
- Diagnostic Performance of Photon-Counting CT Angiography in Vascular Stenosis Assessment: A Systematic Review and Meta-Analysis.Diagnostics (Basel, Switzerland) · 2026Review
- Spectral computed tomography characterization of coronary atherosclerotic plaque: principles, imaging biomarkers, and clinical significance.Frontiers in cardiovascular medicine · 2026Review
- Current State of Computed Tomography Derived Fractional Flow Reserve (FFR-CT) and Its Diagnostic Advantages.Clinical Medicine Insights. Cardiology · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesSevere coronary artery calcification leads to blooming artifacts in conventional coronary CT angiography (CCTA), which may reduce diagnostic accuracy. Ultra-high resolution (UHR) photon-counting detector CT (PCD-CT) reduces calcium blooming. This study aimed to evaluate the diagnostic performance of UHR CCTA with PCD-CT for detecting coronary stenoses in patients with a high coronary calcium burden compared to invasive coronary angiography (ICA). MATERIALS AND
methodsIn this IRB-approved single-center study, patients with Agatston scores > 600 were included, who underwent ICA and coronary UHR PCD-CT angiography within 2 months. 94% of patients underwent CT prior to transcatheter aortic valve replacement. Coronary arteries were graded for diameter stenosis severity (> 50, > 70%) by two blinded, independent readers. Accuracy, sensitivity, and specificity of CCTA were calculated using ICA as the reference standard. Subgroup analyses were performed across Agatston score groups (600-999, 1000-1999, 2000-2999, and > 3000).
results62 patients (mean age, 76 ± 9 years, 16 women) were included. The median Agatston score was 2423 (IQR: 1085-3340). Across all Agatston categories, CCTA demonstrated high diagnostic accuracy and strong agreement with ICA (Cohen's kappa 0.71-1.00). In patients with Agatston scores > 3000 (n = 18), the diagnostic performance of coronary UHR PCD-CT angiography for detecting > 50% (sensitivity 92-100%, specificity 83-100%) and > 70% diameter stenosis (sensitivity 88-100%, specificity 89-100%) remained high for both readers. There was no correlation between the Agatston score and diagnostic error (p > 0.05).
conclusionUHR CCTA with PCD-CT provides high diagnostic performance even in patients with extensive coronary calcifications. KEY POINTS: Question In patients with severe coronary calcification, conventional coronary CT angiography often suffers from blooming artifacts, reducing accuracy and causing unnecessary invasive procedures. Findings Ultra-high resolution coronary angiography with photon-counting detector CT showed high sensitivity and specificity for detecting stenoses, even at Agatston scores > 3000. Clinical relevance Ultra-high resolution coronary CT angiography enables accurate noninvasive detection of stenoses in heavily calcified vessels, potentially reducing invasive coronary angiography.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.