Protocols

PCCT enabled millimeter-scale, layer-specific quantification of carotid perivascular adipose tissue using concentric 1–5 mm annular segmentation. PVAT attenuation decreased progressively with increasing distance from the carotid wall, with significant differences especially between the 1 mm layer and the 3–5 mm layers.…

PCCT showed higher interrater agreement than conventional CT for key structural features in capitellar osteochondritis dissecans. The number of loose bodies and the presence of an osseous bridge demonstrated significantly improved agreement with PCCT compared to conventional CT. Despite higher spatial resolution, several…

The authors found strong agreement between PCCT-derived PBV maps and V/Q-SPECT for whole-lung and lobar perfusion, supporting PCCT as a feasible quantitative perfusion tool in CTEPH work-up. Best-practice implication: PCCT may enable combined assessment of pulmonary perfusion, vasculature, and parenchyma in one…

The authors showed that prone thoracic contrast-enhanced PCCT detected reduced tumor burden after neoadjuvant systemic therapy in all 9 patients. Best-practice implication: when thoracic PCCT is clinically indicated anyway, prone positioning can allow opportunistic local breast tumor and axillary assessment without extra…

PCCT improved CVF detection sensitivity without a significant specificity penalty. Across all three readers, sensitivity was significantly higher for PCCT myelography than for EID-CT myelography, while specificity did not differ significantly. The authors attribute the diagnostic gain mainly to much higher spatial…

Dr. Mustafa Al-Gazzawi, Senior Specialist (Diagnostic Radiology) Dr. Thair S. Abdulla , Head of Radiology, Consultant Radiologist Courtesy of Al‑Ahli Hospital, Doha, Qatar. College of Medicine, QU Health, Qatar University, Doha, Qatar April 13, 2026 Abstract Small bowel ischemia remains difficult to diagnose early,…

Use tin-prefiltered PCCT to reduce lumbar spine dose while preserving subjective image quality. The authors found markedly lower dose with PCCT, while overall subjective image quality remained unchanged versus tin-filtered EID-CT. Expect higher bone-to-fat contrast efficiency with PCCT. Compared with EID-CT, PCCT showed…

Select ~110 keV VMI for optimal artifact reduction. The authors identified 110 keV as the best balance, achieving strongest reduction of hypo- and hyperdense artifacts without overcorrection. Use 110 keV specifically to improve peri-prosthetic bone assessment. Qualitative ratings showed significantly improved evaluation of…

PCCT of the spine provided higher sharpness and lower image noise than EID-CT at a clearly lower radiation dose. In patients with metallic implants, 130 keV monoenergetic reconstructions further improved image quality, artifact reduction, and diagnostic confidence compared with standard PCCT reconstructions. PCCT appears…

Whole-body PCCT provided significantly better subjective and objective image quality than standard EID-CT in patients with multiple myeloma. Image quality improved across overall image quality, edge sharpness, image noise, lesion conspicuity, and diagnostic confidence, while radiation dose was substantially lower. Clinical…

Automated iodine maps on PCCT showed strong diagnostic performance to differentiate renal cysts from neoplasms, with AUC up to 0.99. Renal cysts consistently demonstrated near-zero iodine concentration, while neoplasms showed higher and more heterogeneous iodine values. Minimum iodine concentration in suspicious regions…

PCCT reduced total iodine load by 20.1% for abdominal portal venous phase CT compared with an individualized kV-adapted EID-CT protocol, while maintaining diagnostic image quality. Despite lower liver attenuation at the standard 60 keV reconstruction, PCCT achieved significantly higher SNR and CNR than EID-CT. All scans on…

Mono40 keV images provided the best pancreatic ductal adenocarcinoma conspicuity on PCCT in both arterial and portal venous phases. Quantitatively, tumor-parenchyma attenuation difference and CNR were highest at 40 keV and decreased stepwise with rising keV. Readers still preferred polyenergetic images for overall image…

In this first clinical routine experience, abdominal PCCT achieved superior overall image quality versus conventional CT, with higher Likert scores for general image quality, lower perceived noise, and fewer artifacts. Objective image quality was also better with PCCT, with significantly higher SNR in fat, muscle, and air,…

Lowering the PCCT image quality level from 70 to 50 reduced radiation dose significantly, with SSDE decreasing by 22.8%, without materially compromising image quality. Stone detection remained high across protocols, with detection rates of 91.3% to 100%, while diagnostic confidence stayed consistently high and unaffected…

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…