Photon-counting technology offers new opportunities in imaging high-risk CAD patients

New ultra-high resolution, photon-counting CT technology could offer patients at high risk of coronary artery disease a noninvasive pathway to diagnosis, according to new data published in Radiology

Coronary CT angiography is commonly used to assess patients at low or intermediate risk of CAD but is less effective in high-risk patients with an increased presence of coronary calcifications and stents due to the “blooming” effect they have on imaging. This can result in false positives that lead to further testing that is often invasive in nature, authors of the new study explained. 

Ultra-high resolution coronary CT angiography (UHR-CCTA) has the potential to improve CCTA imaging in high-risk patients by way of photon-counting technology. Photon-counting CT scans emit more photons; they also count and quantify their energy, resulting in improved resolution and detail on imaging—an especially beneficial characteristic in the realm of CAD assessments. 

Lead author of the new study Muhammad T. Hagar, MD, from the Department of Diagnostic and Interventional Radiology at the University of Freiburg in Germany, and colleagues recently tested the utility of UHR-CCTA on a group of 68 patients with severe aortic valve stenosis. When comparing the patients’ UHR-CCTA exams to invasive coronary angiography—the reference standard in high-risk patients—the team observed excellent results using the photon-counting technology. 

On a five-point Likert scale (where 1 represents excellent quality) the technology produced a median overall image quality score of 1.5 and nearly 80% of segments were rated as either good or excellent. 

Hagar said these results suggest that the number of patients who could benefit from noninvasive CCTA could be “significantly broadened by photon-counting detector technology.” 

“This is excellent news for these patients and the imaging community,” Hagar noted. 

Currently, photon-counting technology is not yet widely available. As such, it has not been studied extensively in the CAD population. However, Hagar expects that to change in the coming years. 

“At the University of Freiburg, we had the privilege to work with the technology since its introduction and I am convinced that photon-counting CT is the beginning of a new generation of CT scanners, similar to the introduction to multi-slice CT 30 years ago,” Hagar suggested. 

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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.

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