Cardiac imaging using photon counting CT - benefits, challenges and prospects.

Photon counting detector CT (PCD-CT) is a recent advance in CT technology that offers several advantages in cardiac imaging, including ultra-high resolution (UHR), improved spectral imaging, increased iodine signal, decreased noise and artifacts, and improved radiation dose efficiency. UHR in PCD-CT improves assessment of coronary artery stenosis, stents and plaque. Spectral imaging allows lower dosage of iodinated contrast, decreases several artifacts and characterizes materials, which can be useful for removing calcific plaques, computing virtual calcium score from CTA, characterizing lesions and evaluating myocardial perfusion, late iodine enhancement and quantifying extracellular volume. In this article, we review the current clinical evidence for benefits rendered by PCD-CT in cardiac imaging, highlight key challenges and discuss prospects.