Araki Suguru, Nakamura Satoshi, Okabe Shiko, Takafuji Masafumi, Ichikawa Yasutaka, Sakuma Hajime, Kitagawa Kakuya
Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
Department of Advanced Diagnostic Imaging, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
Jpn J Radiol. 2025 Aug 9. doi: 10.1007/s11604-025-01846-x.
This study aimed to evaluate the feasibility of low-tube-potential ultra-high-resolution (UHR) coronary CT angiography (CCTA) using photon-counting detector CT (PCD-CT) in comparison to low-tube-potential CCTA using energy-integrating detector CT (EID-CT), with a specific focus on the evaluation of coronary stents.
This retrospective study included 54 patients (88 stents) who underwent CCTA in UHR mode on PCD-CT at low tube potential (PCD-low; 27 patients [45 stents]) or CCTA with EID-CT at low tube potential (EID-low; 27 patients [43 stents]). The EID-low cohort was selected by propensity score matching to the PCD-low cohort. Image quality of in-stent lumen was assessed using a 4-point Likert scale, with a score of 4 indicating "excellent." Quantitative assessment of stents included stent-induced blooming, edge sharpness, stent full width at half maximum (FWHM) and ΔHU which quantifies the increase in CT attenuation within the stent lumen. Radiation dose was evaluated using CT dose index volume (CTDIvol) and dose-length product (DLP).
PCD-low had higher image quality scores than EID-low (scores of 3 and 4, 82.2% vs. 53.5%; p = 0.02). PCD-low showed reduced stent-induced blooming, superior edge sharpness, smaller stent FWHM and smaller ΔHU than EID-low (all, p < 0.01). CTDIvol and DLP in PCD-low (9.3 ± 4.4 mGy and 107.1 ± 50.4 mGy・cm) were comparable to those of EID-low (10.5 ± 5.9 mGy and 118.2 ± 74.9 mGy・cm), respectively. (p = 0.26 and 0.47).
CCTA using UHR mode in PCD-CT at low tube potential achieved superior image quality for implanted stent visualization as compared to EID-CT at low tube potential, while maintaining comparable radiation doses.
本研究旨在评估使用光子计数探测器CT（PCD-CT）的低管电压超高分辨率（UHR）冠状动脉CT血管造影（CCTA）与使用能量积分探测器CT（EID-CT）的低管电压CCTA相比的可行性，特别关注冠状动脉支架的评估。
这项回顾性研究纳入了54例患者（88个支架），这些患者在低管电压下以UHR模式在PCD-CT上接受了CCTA（PCD-低组；27例患者[45个支架]）或在低管电压下以EID-CT接受了CCTA（EID-低组；27例患者[43个支架]）。EID-低组通过倾向评分匹配选择，使其与PCD-低组相匹配。使用4分李克特量表评估支架内管腔的图像质量，4分表示“优秀”。对支架的定量评估包括支架引起的模糊、边缘清晰度、支架半高宽（FWHM）和ΔHU，后者量化支架管腔内CT衰减的增加。使用CT剂量指数容积（CTDIvol）和剂量长度乘积（DLP）评估辐射剂量。
PCD-低组的图像质量评分高于EID-低组（3分和4分的比例分别为82.2%和53.5%；p = 0.02）。与EID-低组相比，PCD-低组显示出支架引起的模糊减少、边缘清晰度更好、支架FWHM更小以及ΔHU更小（所有p < 0.01）。PCD-低组的CTDIvol和DLP（分别为9.3±4.4 mGy和107.1±50.4 mGy·cm）与EID-低组（分别为10.5±5.9 mGy和118.2±74.9 mGy·cm）相当（p = 0.26和0.47）。
与低管电压的EID-CT相比，在低管电压下使用PCD-CT的UHR模式进行CCTA在植入支架可视化方面实现了更高的图像质量，同时保持了相当的辐射剂量。
