ArticleEuropean heart journal. Imaging methods and practice2026
Single-session photon-counting CT protocol for simultaneous screening of coronary and carotid artery disease and lung pathology.
Article in European heart journal. Imaging methods and practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Aims: Preventive imaging for cardiothoracic risk is fragmented across separate pathways. Photon-counting CT (PCCT) may consolidate coronary, aortic-carotid, and pulmonary assessment into a single session while maintaining diagnostic performance and controlling dose. Methods and results: ACTA is an ongoing, general-practitioner-initiated, risk-enriched screening study (age 45-75 years; diabetes ≥10 years, current/recent smoking, or Framingham hard coronary artery disease risk ≥10%). The protocol integrates non-contrast calcium scoring, ultra-high-resolution coronary CT angiography, a high-pitch thoraco-cervical sweep, and brief late iodine enhancement (LIE). Incidental findings trigger predefined, guideline-concordant referrals. The primary endpoint is the prevalence of obstructive (≥50%) and/or extensive (≥2-vessel) coronary artery disease. This interim analysis includes participants imaged 11 January to 21 June 2025. Of 223 invited, 172 underwent PCCT; all completed without complications. Mean dose-length product was ∼740 mGy·cm; the effective dose was 12.6 mSv (IQR 10.5-17.1 mSv), and weight-adapted contrast equalled ∼0.44-0.48 gI/kg. Any coronary atherosclerosis was present in 129/172 (75%); the primary endpoint was met in 98/172 (57%). Carotid plaques occurred in 94/170 (55%); lung-RADS 3-4 in 16/172 (9%); emphysema in 41/172 (24%). Management actions included invasive coronary angiography in 8/172 (5%), targeted vascular and pulmonary referrals, initiation/intensification of prevention therapies, and structured follow-up. Incidental extracardiac findings were common but managed via protocolized pathways. Conclusion: Single-session PCCT feasibly consolidates comprehensive cardiothoracic assessment with controlled radiation/iodine exposure and structured downstream care. Preliminary yield suggests actionable information in high-risk, asymptomatic adults; ongoing follow-up and prespecified economic analyses will determine clinical outcomes and cost-effectiveness.
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