Evidence map›Paper›PMID 41733596›Full record

Trial reportEuropean radiology experimental2026

Feasibility of ultra-low flow rate coronary CT angiography using photon-counting detector CT: a prospective randomized trial.

Shuangxiang Lin, Cuiliu Liu, Yalan Zhou, Qinlan Chen, Shuyue Wang, Jiaxing Wu, Xinhong Wang, Jianzhong Sun

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in European radiology experimental, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Shuangxiang LinDepartment of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Cuiliu LiuDepartment of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Yalan ZhouDepartment of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Qinlan ChenDepartment of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Shuyue WangDepartment of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Jiaxing WuSiemens Healthineers, Siemens, Shanghai, China.
Xinhong WangSiemens Healthineers, Siemens, Shanghai, China.
Jianzhong SunDepartment of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China. 2191009@zju.edu.cn.ORCID http://orcid.org/0000-0002-6099-4452

Funding

The Medical Science and Technology Project of Zhejiang Province 2021KY393The National Key Research and Development Program of China 2018YFE0198400
6 · The paper itself

Abstract

objectiveThis study evaluates the feasibility of photon-counting detector CT (PCD-CT)-based coronary CT angiography (CCTA) using ultra-low flow contrast rate while maintaining diagnostic image quality. MATERIALS AND

methodsIn this prospective trial, 292 patients underwent CCTA assigned to one of three protocols: ultra-low (1.5-1.8 mL/s) or routine (4.0-5.0 mL/s) contrast injection with PCD-CT, or routine injection with EID-CT. All scans utilized a high-pitch prospective electrocardiogram-triggering acquisition. PCD-CT images were reconstructed at 45 keV (ultra-low) or 60 keV (routine). Objective image quality was quantitatively assessed by measuring vessel attenuation, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). Subjective image quality parameters (vascular contrast, image noise, artifacts, and vessel clarity) were independently evaluated by two blinded readers using a 4-point Likert scale (1: non-diagnostic; 2: adequate; 3: good; 4: excellent).

resultsObjective image quality demonstrated comparable attenuation, CNR, and SNR in proximal coronary segments across all groups (all p > 0.05). The ultra-low PCD-CT protocol significantly lowers attenuation in the distal LAD (373.20 ± 49.58 HU) compared to routine protocols (PCD-CT: 393.52 ± 49.38 HU; EID-CT: 396.72 ± 47.55 HU; p = 0.01). While distal vessel clarity scores were modestly reduced in distal vessel clarity (ultra-low PCD-CT: 2.91 ± 0.81 versus routine PCD-CT: 3.58 ± 0.50 versus routine EID-CT: 3.54 ± 0.50; p < 0.01).

conclusionFor patients with difficulty establishing venous access routes, ultra-low contrast agent flow rates in PCD-CT maintain objective image quality comparable to that of standard protocols, with acceptable diagnostic performance despite slight reductions. RELEVANCE STATEMENT: Photon-counting detector CT (PCD-CT) maintains objective coronary CT angiography image quality comparable to standard protocols even at ultra-low contrast flow rates (1.5-1.8 mL/s), offering a clinically acceptable and safer alternative for patients with challenging venous access. KEY POINTS: First validation of ultra-low flow contrast rate CCTA using photon-counting CT (PCD-CT). Ultra-low flow rates maintain objective image quality (CNR/SNR) versus routine protocols. PCD-CT enables 50% contrast reduction without diagnostic compromise.

Indexed as

Computed Tomography AngiographyCoronary AngiographyAgedContrast MediaFeasibility StudiesFemaleHumansMaleMiddle AgedPhotonsProspective StudiesSignal-To-Noise RatioContrast MediaContrast mediaCoronary CT angiographyImage qualityPhoton-counting detector CTUltra-low contrast flow rate

Identifiers

PMID41733596
PMCPMC12932791

What Socratic holds

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LicenceCC BY
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Registered trials

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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.