Cardiology

PCCT significantly improved specificity, PPV, and overall diagnostic accuracy for obstructive CAD compared to EID-CT, while maintaining equally high sensitivity and NPV. Fewer patients were referred to invasive coronary angiography after PCCT, but those referred were more likely to undergo revascularization, indicating…

Combined spectral and UHR PCCT improved coronary stent assessment by balancing maximum spatial detail with more stable spectral reconstructions. UHR images provided the best lumen visibility and lowest strut overestimation at 60 bpm, but image quality declined at higher heart rates because of motion sensitivity. Spectral…

Biphasic PCCT with virtual noniodine VNI achieved endoleak detection comparable to triphasic CT with true noncontrast imaging after EVAR. Subjective image quality and image noise were similar between true non-contrast (TNC) and VNI, while phantom analysis showed slightly lower objective noise for VNI. Using VNI instead of…

UHR dual-source PCCT delivered at least good image quality in 94% of coronary segments and very good or excellent quality in 85%, despite relatively high heart rates. Image quality for coronary stents was particularly strong, with 92% of stented segments rated excellent. Only limited motion, stack, and metal artifacts were…

Among the tested reconstruction settings, kernel Bv40 provided the best overall balance of sharpness, noise, and CNR for high-pitch spectral coronary PCCT. Increasing kernel sharpness improved vessel sharpness but also increased image noise and reduced CNR, highlighting the trade-off between detail and noise. Subjective…

In FLASH-mode coronary PCCT, heart rate variability, not mean heart rate, was the strongest predictor of reduced diagnostic image quality. Both heart rate and heart rate variability were associated with motion artifacts, but only heart rate variability independently predicted lower image quality. These findings support the…

The novel ZeeFree reconstruction significantly reduced the frequency and severity of stair-step artifacts in sequential UHR coronary PCCTA. Most coronary segments that were nondiagnostic due to stair-step artifacts on standard reconstruction became diagnostic with ZeeFree, without compromising noise, SNR, or CNR. Heart…

Compared with conventional VMI, VNCa images on spectral PCCT markedly reduced overestimation of calcified coronary stenoses and aligned much more closely with 3D-QCA. Virtual calcium removal was feasible in most lesions, but about 12% of stenoses had to be excluded because of erroneous plaque subtraction. When feasible,…

UHR photon-counting CCTA achieved high diagnostic accuracy for detecting CAD in a high-risk TAVR population, despite severe calcification and prior stent placement. Image quality was excellent overall, with 97.8% of coronary segments rated diagnostic and 79% rated good or excellent. The study suggests that UHR PCCT may…

Ultra-high-resolution PCCT reconstructions reduced apparent calcified plaque burden and increased visualization of non-calcified plaque components compared with standard reference reconstructions. The combination of 0.2 mm slice thickness and the sharp Bv64 kernel yielded the lowest calcified plaque fraction and the…

VNC-based coronary calcium scoring on PCCT showed strong correlation with TNC scoring, but systematically underestimated Agatston scores by about 11% overall. Agreement in CAC severity category was 80%, but around 11% of patients were misclassified, which could potentially affect treatment decisions. Accuracy was best in…

Dual-source PCD-CCTA delivered very good image quality, high contrast-to-noise ratio, and 95% assessability of coronary segments in a real-world multicenter setting. Coronary segment assessability remained high with low to moderate calcium burden, but declined with very high Agatston scores above 600 and with higher heart…

Higher temporal resolution with dual-source CT (66 ms) reduced motion blur and led to significantly lower CAC, AVC, and MAC scores than 125 ms reconstructions. Lower temporal resolution (125 ms) overestimated calcium burden and led to reclassification of risk categories in 4% of CAC cases and 11% of AVC cases. The study…

Compared with standard-resolution (SR) PCCTA, ultrahigh-resolution (UHR) PCCTA achieved clearly stronger correlation with invasive FFR and higher diagnostic accuracy for functionally significant stenosis. UHR-PCCTA-derived FFR maintained performance in heavily calcified and diffusely diseased vessels, where…

@Lili Száraz, @Samuel Dr. Beke, @Kristóf Nagy, Barnabás Baksa, MD, Péter Hegedűs, MD, PhD, Prof. Pál Maurovich-Horvat, MD, PhD Medical Imaging Center, Semmelweis University, Budapest, Hungary January 29, 2026 History A 50-year-old male patient presented to the emergency department (ED) with massive hemoptysis, dyspnea, and…