ArticleJACC. Cardiovascular imaging2025
Benchmarking Photon-Counting Computed Tomography Angiography Against Invasive Assessment of Coronary Stenosis: Implications for Severely Calcified Coronaries.
Article in JACC. Cardiovascular imaging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Comparison of photon-counting CT angiography with energy-integrating CT angiography in coronary artery stenosis: a systematic review and meta-analysis.BMC medical imaging · 2025Pooled it
- A scoping review of photon-counting detector computed tomography in cardiovascular imaging.Diagnostic and interventional radiology (Ankara, Turkey) · 2026Article
- First performance test of a dual wide-coverage CT system.European radiology · 2026Article
- Photon-Counting Computed Tomography for In-Stent Occlusion: Lumen Visualization and Myocardial Viability.JACC. Case reports · 2026Article
- Response to "Photon-Counting CT in Cardiovascular Imaging: From Technical Promise to Clinical Translation".Korean journal of radiology · 2026Article
- Clinical benefits and current challenges of photon-counting detector CT in vascular imaging.Radiology advances · 2026Review
- Diagnostic Performance of Photon-Counting CT Angiography in Vascular Stenosis Assessment: A Systematic Review and Meta-Analysis.Diagnostics (Basel, Switzerland) · 2026Review
- Cardiac imaging using photon counting CT - benefits, challenges and prospects.The international journal of cardiovascular imaging · 2026Review
- Photon-Counting CT in Cardiovascular Imaging: Clinical Applications.Korean journal of radiology · 2026Review
- Cardiac CT for personalized phenotyping in stable coronary artery disease: toward precision medicine.BJR open · 2026Review
- Current State of Computed Tomography Derived Fractional Flow Reserve (FFR-CT) and Its Diagnostic Advantages.Clinical Medicine Insights. Cardiology · 2026Review
- Prospective comparison of ultra-high-resolution photon-counting detector CT coronary angiography versus conventional CT.The British journal of radiology · 2026Article
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21 authors.
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Abstract
backgroundClinical guidelines do not recommend coronary computed tomographic angiography (CTA) in elderly patients or in the presence of heavy coronary calcification. Photon-counting coronary computed tomographic angiography (PCCTA) introduces ultrahigh in-plane resolution and multienergy imaging, but the ability of this technology to overcome these limitations is unclear.
objectivesThe authors evaluate the ability of PCCTA to quantitatively assess coronary luminal stenosis in the presence and absence of calcification, comparing both the ultrahigh-resolution (UHR)-PCCTA and the multienergy standard-resolution (SR)-PCCTA with the criterion-standard 3-dimensional invasive quantitative coronary angiography (3D QCA).
methodsThe authors included 100 patients who had both PCCTA and invasive coronary angiography (ICA). They comparatively evaluated luminal diameter stenosis with PCCTA and 3D QCA, anatomic disease severity (according to CAD-RADS [Coronary Artery Disease-Reporting and Data System]) and the diagnostic performance of PCCTA in identifying coronary arteries with ≥50% diameter stenosis on 3D QCA requiring invasive hemodynamic severity evaluation and/or revascularization.
resultsThe authors analyzed 257 vessels and 343 plaques. UHR-PCCTA luminal evaluation relative to 3D QCA was more precise than SR-PCCTA (median difference: 3% [Q1-Q3: 1%-6%] vs 6% [Q1-Q3: 2%-11%]; P < 0.001), particularly in severely calcified arteries (median difference 3% [Q1-Q3: 1%-6%] vs 6% [Q1-Q3: 3%-13%]; P = 0.002). Per-vessel agreement for CAD-RADS between UHR-PCCTA and 3D QCA was near-perfect (κ = 0.90 [Q1-Q3: 0.84-0.95]; P < 0.001), and it was substantial for SR-PCCTA (κ = 0.63 [Q1-Q3: 0.54-0.71]; P < 0.001), especially in severely calcified arteries: κ = 0.90 (Q1-Q3: 0.83-0.97; P < 0.001) and κ = 0.67 (Q1-Q3: 0.56-0.77; P < 0.001), respectively. Per-vessel diagnostic performance of SR- and UHR-PCCTA was excellent: AUC: 0.94 (95% CI: 0.91-0.98; P < 0.001) and 0.99 (95% CI: 0.98-1.00; P < 0.001), respectively. UHR-PCCTA diagnostically outperformed SR-PCCTA: ΔAUC: 0.05 (95% CI: 0.01-0.08; P = 0.01).
conclusionsPCCTA compares favorably with ICA for lumen assessment and anatomic disease severity classification in patients presenting with acute coronary syndrome or patients referred for ICA. UHR-PCCTA luminal evaluation is superior to SR-PCCTA, especially in patients with heavy coronary calcification. UHR-PCCTA has excellent diagnostic performance in identifying coronary arteries with ≥50% luminal stenosis on 3D QCA, outperforming standard-resolution imaging.
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