Revolutionary photon-counting CT: A noninvasive approach to detect heart disease in high-risk patients

 New ultra-high-resolution CT technology enables excellent image quality and accurate diagnosis of coronary artery disease in high-risk patients, a potentially significant benefit for people previously ineligible for noninvasive screening, according to a study published in a Radiology journal.

Coronary CT angiography (CCTA) in a high-risk population is difficult due to the high prevalence of coronary calcifications and stents. Coronary calcifications tend to “bloom” on CCTA, making them appear more extensive than they really are. This results in an overestimation of blockages and plaque and false-positive results.

Ultra-high-resolution coronary CT angiography (UHR-CCTA) is a promising tool for the noninvasive assessment of patients at high risk for coronary artery disease. Because it uses recently introduced photon-counting CT scanners, it has not been extensively studied.

Dr. Hagar and colleagues compared the diagnostic accuracy of UHR-CCTA with that of the reference standard of invasive coronary angiography (ICA) in 68 patients. The patients had severe aortic valve stenosis, a common, serious valve disease that reduces or blocks blood flow from the heart to the aorta.

UHR-CCTA was highly sensitive and specific for coronary artery disease detection. It delivered a median overall image quality score of 1.5 on the 5-point Likert scale, where 1 is excellent and 5 is non-diagnostic. Almost 80% of segments are rated as good or excellent.

Reference: Muhammad T. Hagar et al, Accuracy of Ultrahigh-Resolution Photon-counting CT for Detecting Coronary Artery Disease in a High-Risk Population, Radiology