Cardiology

@Bálint Szilveszter, Borbála Vattay, Péter Csongor, @Milan Vecsey-Nagy Városmajor Heart and Vascular Centre, Cardiac CT Working Group, Budapest, Hungary September 29, 2026 History Why did the patient come for a CT exam? A 63-year-old female patient, presenting with typical chest pain, was referred for coronary imaging to…

Ferenc Imre Suhai, Barbara Sipos, Milán Vecsey-Nagy, Bálint Szilveszter Városmajor Heart and Vascular Centre, Cardiac CT Working Group, Budapest, Hungary September 29, 2026 History Why did the patient come for a CT exam? A 29-year-old male patient, with a history of hypertension and bronchial asthma, was referred to the…

In 71 post-TAVI PCCT examinations from 63 patients, time-resolved cardiac PCCT enabled calculation of prosthetic-valve hemodynamics from left-ventricular volumetry and direct valve-orifice planimetry. CT-derived mean and maximum transvalvular gradients correlated strongly with echocardiography (ρ = 0.85 for both), while…

This early case series illustrates how UHR PCCT can improve structural heart imaging before and after TAVR, particularly through sharper depiction of the aortic valve, annulus, coronary arteries, prosthetic valve frames, and vascular access routes. UHR acquisition allows 0.2-mm sections, compared with 0.4 mm in the regular…

In 110 patients undergoing EVAR surveillance, including 41 endoleaks, the authors compared conventional triphasic PCCT (true noncontrast + arterial + venous) with a biphasic strategy in which virtual noniodine (VNI) images reconstructed from the venous phase replaced the true noncontrast acquisition. Endoleak detection was…

In 69 patients with 131 coronary stents, UHR PCCT with 0.2-mm slices significantly improved in-stent lumen visualization and reduced blooming artifacts compared with standard-resolution 0.6-mm reconstruction. Among the evaluated reconstruction kernels, Bv72 provided the best overall performance, improving visualization of…

In 124 patients with CCTA and invasive coronary angiography (ICA) within 30 days, diagnostic performance of PCCT CCTA was similar with and without sublingual nitroglycerin. Per-patient sensitivity was 90.3% vs 90.9%, and NPV was 86.4% vs 88.9%, with no significant differences between groups. The non-nitroglycerin group was…

In 51 patients with 51 coronary plaques, PCCT VMI energy had a substantial effect on measured plaque attenuation and consequently on quantitative plaque composition when fixed HU thresholds were used. Mean plaque attenuation fell progressively from 723 ± 501 HU at 40 keV to 120 ± 112 HU at 180 keV, while 70-keV VMI most…

The case report hase been published by: Tateishi, R, Nishimura, T, Tao, S. et al. Photon-Counting Detector Computed Tomography Depicts a Ventricular Tachycardia Substrate: Periaortic Septal Intramural Late Iodine Enhancement. J Am Coll Cardiol Case Rep. 2026 Apr, 31 (15) . https://doi.org/10.1016/j.jaccas.2026.107250 Check…

In 18 patients with 44 coronary stents, ultra-high-resolution (UHR) PCCT angiography achieved high diagnostic accuracy for detecting ≥50% in-stent stenosis compared with invasive coronary angiography (ICA). Both readers identified all 5 stenotic stents, yielding 100% sensitivity. Specificity and overall accuracy were 92.3%…

In 170 patients, coronary artery calcium scores derived from PCCT PureCalcium virtual noncontrast images showed excellent correlation with true noncontrast (TNC) calcium scoring (ICC 0.98). Median Agatston scores were not significantly different: 4.8 vs 2.7, respectively (p = 0.99). High correlation did not translate into…

In 27 patients undergoing same-day PCCT and cardiac MRI, myocardial extracellular volume (ECV) measurements remained robust across a wide range of reconstruction settings, but reconstruction choices meaningfully affected agreement with MRI. The greatest improvement came from combining thin slices with low-keV VMI, rather…

Standard PCCT virtual noncontrast (VNC) calcium scoring performs well for larger and denser plaques but can miss subtle disease. Large/medium and high/medium-density plaques showed strong agreement with true noncontrast (TNC) scoring (r > 0.9; ICC ≥ 0.90), whereas low-density plaques showed poor agreement and small plaques…

Evaluated whether coronary artery calcium scoring (CACS) can be derived directly from contrast-enhanced CCTA using the PCCT-specific PureCalcium virtual noniodine reconstruction, potentially eliminating the separate true noncontrast (TNC) calcium-score acquisition. Tested on a first-generation dual-source photon-counting…

In this prospective same-day comparison of 29 patients, myocardial extracellular volume (ECV) measured with PCCT showed strong agreement with cardiac MRI, supporting spectral PCCT as a quantitative tool for myocardial tissue characterization. Dual-energy PCCT achieved correlations of r = 0.91 for global ECV and r = 0.82…

In 58 infants <10 kg, cardiac PCCT at 70 kV and 120 kV provided comparable image quality, with similar aortic CNR and median subjective image-quality scores of 5/5 in both groups. 70 kV reduced radiation dose by almost 50%, with CTDI decreasing from 0.25 mGy at 120 kV to 0.13 mGy at 70 kV (P<0.001). The key trade-off is…

A novel spectral black-blood CT (BBCT) reconstruction used the spectral information from PCCT to suppress intraluminal iodine from a routine single-phase CTA dataset, enabling high-resolution carotid vessel wall imaging without an additional scan, contrast administration, or dedicated acquisition. Compared with…

PCCT reduced overestimation of coronary artery calcium compared with conventional energy-integrating detector CT (EID-CT), addressing the well-known impact of calcium blooming, partial-volume effects, beam hardening, and motion artifacts on coronary calcium assessment. The study used native coronary arteries from 10…

Learning objectives To provide a basic understanding of CCT technology and use of different scan protocols according to the clinical questions To describe what information can be obtained from a CCT study for a variety cardiac conditions and how this can affect clinical management To know indications for CCT for the…

Cardiac PCCT integrated directly into the acute stroke CT workflow achieved 96% diagnostic accuracy, 90% sensitivity, 97% specificity, and a particularly strong 99% negative predictive value for left atrial appendage (LAA) thrombus compared with TEE. The cardiac acquisition was added immediately after stroke CTA with only…

Photon-counting detector (PCD) coronary CT showed less calcium blooming than conventional energy-integrating detector (EID) CT, resulting in systematically lower visual estimates of coronary luminal stenosis. In 25 patients scanned with both systems on the same day, median visual stenosis decreased from 31.8% to 20.6% for…

Access publication Key takeaways UHR PCCTA significantly improved the assessment of calcified coronary stenoses by reducing calcium blooming artifacts, resulting in more accurate stenosis quantification than standard-resolution CCTA. Compared with standard-resolution imaging, UHR PCCTA reclassified 54.4% of patients to a…

Access publication Key takeaways UHR PCCTA provided significantly more accurate measurements of calcified and partially calcified coronary stenoses than conventional energy-integrating detector (EID) CCTA, while maintaining comparable radiation dose and contrast media volume. The improved spatial resolution of PCCT reduced…

This phantom study demonstrates that ultra-high-resolution (UHR) photon-counting CT (PCCT) substantially improves visualization of low-attenuation plaque (LAP) compared with standard-resolution PCCT and a clinically used energy-integrating detector CT (EID-CT) protocol. The combination of UHR acquisition (120 × 0.2 mm…