Coronary artery stenosis quantification in patients with dense calcifications using ultra-high-resolution photon-counting-detector computed tomography

To quantify differences in coronary artery stenosis severity in patients with calcified lesions between conventional energy-integrating detector (EID) CT and ultra-high-resolution (UHR) photon-counting-detector (PCD) CT. Patients undergoing clinically indicated coronary CT angiography were prospectively recruited and scanned first on an EID-CT (SOMATOM Force, Siemens Healthineers) and then a PCD-CT (NAEOTOM Alpha, Siemens Healthineers) on the same day. EID-CT was performed with standard mode (192 ​× ​0.6 ​mm detector collimation) following our clinical protocol. PCD-CT scans were performed under UHR mode (120 ​× ​0.2 ​mm detector collimation). For each patient, left main, left anterior descending, right coronary artery, and circumflex were reviewed and the most severe stenosis from dense calcification for each coronary was quantified using commercial software. Additionally, each measured stenosis was assigned a severity category based on percent diameter stenosis, and changes in severity category across EID-CT and PCD-CT were assessed. A total of 23 patients were enrolled, with 34 coronary artery stenoses analyzed. Stenosis was significantly reduced in PCD-CT compared to EID-CT (p ​