Ultrahigh Spatial-Resolution PCD CT Improves Assessment of Calcified Stenoses

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Use of ultrahigh spatial-resolution photon-counting detector CT reconstruction improved in vivo, in vitro coronary stenosis assessment

By Elana Gotkine HealthDay Reporter

TUESDAY, Feb. 27, 2024 (HealthDay News) — Use of ultrahigh spatial-resolution photon-counting detector (PCD) computed tomography (CT) improves in vivo and in vitro coronary stenosis assessment for calcified stenoses, according to a study published online Feb. 20 in Radiology.

Moritz C. Halfmann, M.D., from the University Medical Center of the Johannes Gutenberg-University in Germany, and colleagues examined the effect of improved spatial resolution on coronary stenosis assessment and reclassification. Coronary stenoses were assessed prospectively in a vessel phantom (in vitro) containing two stenoses of 25 and 50 percent and retrospectively in 114 patients (in vivo) who underwent ultrahigh spatial-resolution cardiac PCD CT. Images were reconstructed at standard resolution, high spatial resolution, and ultrahigh spatial resolution; the percentages of diameter stenosis (DS) were compared between reconstructions.

The researchers found that for both 25 and 50 percent stenoses, in vitro percentage DS measurements were significantly more accurate with increasing spatial resolution (mean bias for standard, high spatial, and ultrahigh spatial resolution, 10.1, 8.0, and 2.3 percent, respectively). Decreasing median percentage DS with increasing spatial resolution for calcified stenoses was confirmed by in vivo results (standard, high spatial, and ultrahigh spatial resolution: 41.5, 34.8, and 26.7 percent, respectively). No evidence of a difference was seen for noncalcified and mixed plaques. Reclassification of 62 of 114 patients to a lower Coronary Artery Disease Reporting and Data System category occurred with use of ultrahigh spatial-resolution reconstruction compared with standard resolution.

“Ultrahigh spatial resolution at photon-counting detector coronary CT angiography leads to relevant rates of stenosis reclassification, which may influence the rate of downstream testing in patients with stable chest pain,” the authors write.

Several authors disclosed ties to the biopharmaceutical and medical technology industries.

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