ArticleMedical physics2023
Technical note: Exploring the detectability of coronary calcification using ultra-high-resolution photon-counting-detector CT.
Article in Medical physics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 6 citations in OpenAlex.
- Coronary artery calcium scoring: expanding the new standard by photon-counting detector CT-Part I: Impact of tube voltage, tube current, slice thickness, and quantum iterative reconstructions.European radiology · 2026Article
- Spatial resolution improvements for photon counting detectors using coincidence counting and frequency weighted reconstruction.Medical physics · 2025Article
- Technical principles, benefits, challenges, and applications of photon counting computed tomography in coronary imaging: a narrative review.Cardiovascular diagnosis and therapy · 2024Review
- Spectral Photon-Counting Computed Tomography: Technical Principles and Applications in the Assessment of Cardiovascular Diseases.Journal of clinical medicine · 2024Review
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
backgroundCoronary calcification is a strong indicator of coronary artery disease, and patients with a "zero" coronary calcification score have a much lower risk of future cardiac events than those with even small amounts of calcium. However, false-negative (incorrect zero scores) may occur if small calcifications are missed at CT due to limited spatial resolution. PURPOSE: To demonstrate lower limits of detection for coronary calcification using an ultra-high-resolution (UHR) mode on a clinical photon-counting-detector CT (PCD-CT), compared to a conventional energy-integrating-detector CT (EID-CT).
methodsChicken eggshell fragments (0.4-0.8 mm) mimicking coronary calcifications were scanned on a clinical PCD-CT (NAEOTOM Alpha) in UHR mode and a conventional EID-CT (SOMATOM Force) with matched tube potential and radiation dose levels to the PCD-CT. PCD-CT images were reconstructed with a sharp kernel (Qr68) and a quantum iterative algorithm (QIR-3). Two sets of EID-CT images were reconstructed: routine clinical kernel (Qr36, ADMIRE-3) and a sharper kernel (Qr54) with similar noise to PCD-CT images. With institutional review board approval, in vivo exams performed with the PCD-CT in UHR mode were compared against patients' clinical EID-CT exams. The visibility of calcifications on PCD-CT and EID-CT images was assessed and compared qualitatively.
resultsPCD-CT images visualized all calcified fragments, while EID-CT failed to detect those below 0.6 mm using a routine protocol. EID-CT with Qr54 improved visibility but distorted boundaries. Calcifications were less visible on EID-CT than PCD-CT as phantom sizes increased. 0.6- and 0.7-mm calcified fragments were barely visible on 35- and 40-cm phantom EID-CT images. Patient cases showed small calcifications missed on EID-CT but detected on PCD-CT.
conclusionAt matched radiation dose, PCD-CT in UHR mode provided higher spatial resolution and improved the detectability of small calcified fragments for different phantom/patient sizes in comparison to EID-CT.
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