Next Article in Journal
Advancing the Understanding of Oral Health Through Multidisciplinary and Translational Perspectives Insights from a Special Issue of the Journal of Clinical Medicine
Previous Article in Journal
Glycocalyx-Shedding and Inflammatory Reactions Occur Yet Do Not Predict Complications Resulting from an Esophagectomy in an Accelerated Recovery After Surgery Program
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
JCM
Volume 14
Issue 17
10.3390/jcm14176049
jcm-logo
Submit to this Journal Review for this Journal Propose a Special Issue
► Article Menu

Article Menu

share Share announcement Help format_quote Cite
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Photon-Counting CT Enhances Diagnostic Accuracy in Stable Coronary Artery Disease: A Comparative Study with Conventional CT

by
Mitsutaka Nakashima
1,
Toru Miyoshi
1,*,
Shohei Hara
1,
Ryosuke Miyagi
1,
Takahiro Nishihara
1,
Takashi Miki
1,
Kazuhiro Osawa
2 and
Shinsuke Yuasa
1
1
Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
2
Department of General Internal Medicine 3, Kawasaki Medical School General Medicine Centre, Okayama 700-8505, Japan
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(17), 6049; https://doi.org/10.3390/jcm14176049 (registering DOI)
Submission received: 6 July 2025 / Revised: 20 August 2025 / Accepted: 24 August 2025 / Published: 26 August 2025
(This article belongs to the Section Cardiovascular Medicine)
Versions Notes

Abstract

Background/Objectives: Coronary CT angiography (CCTA) is a cornerstone in evaluating stable coronary artery disease (CAD), but conventional energy-integrating detector CT (EID-CT) has limitations, including calcium blooming and limited spatial resolution. Photon-counting detector CT (PCD-CT) may overcome these drawbacks through enhanced spatial resolution and improved tissue characterization. Methods: In this retrospective, propensity score–matched study, we compared CCTA findings from 820 patients (410 per group) who underwent either EID-CT or PCD-CT for suspected stable CAD. Primary outcomes included stenosis severity, high-risk plaque features, and downstream invasive coronary angiography (ICA) referral and yield. Results: The matched cohorts were balanced in demographics and cardiovascular risk factors (mean age 67 years, 63% male). PCD-CT showed a favorable shift in stenosis severity distribution (p = 0.03). High-risk plaques were detected less frequently with PCD-CT (22.7% vs. 30.5%, p = 0.01). Median coronary calcium scores did not differ (p = 0.60). Among patients referred for ICA, those initially evaluated with PCD-CT were more likely to undergo revascularization (62.5% vs. 44.1%), and fewer underwent potentially unnecessary ICA without revascularization (3.7% vs. 8.0%, p = 0.001). The specificity in diagnosing significant stenosis requiring revascularization was 0.74 with EID-CT and 0.81 with PCD-CT (p = 0.04). Conclusions: PCD-CT improved diagnostic specificity for CAD, reducing unnecessary ICA referrals while maintaining detection of clinically significant disease. This advanced CT technology holds promise for more accurate, efficient, and patient-centered CAD evaluation.
Keywords: photon-counting CT; coronary CT angiography; diagnostic accuracy; invasive coronary angiography photon-counting CT; coronary CT angiography; diagnostic accuracy; invasive coronary angiography

Share and Cite

MDPI and ACS Style

Nakashima, M.; Miyoshi, T.; Hara, S.; Miyagi, R.; Nishihara, T.; Miki, T.; Osawa, K.; Yuasa, S. Photon-Counting CT Enhances Diagnostic Accuracy in Stable Coronary Artery Disease: A Comparative Study with Conventional CT. J. Clin. Med. 2025, 14, 6049. https://doi.org/10.3390/jcm14176049

AMA Style

Nakashima M, Miyoshi T, Hara S, Miyagi R, Nishihara T, Miki T, Osawa K, Yuasa S. Photon-Counting CT Enhances Diagnostic Accuracy in Stable Coronary Artery Disease: A Comparative Study with Conventional CT. Journal of Clinical Medicine. 2025; 14(17):6049. https://doi.org/10.3390/jcm14176049

Chicago/Turabian Style

Nakashima, Mitsutaka, Toru Miyoshi, Shohei Hara, Ryosuke Miyagi, Takahiro Nishihara, Takashi Miki, Kazuhiro Osawa, and Shinsuke Yuasa. 2025. "Photon-Counting CT Enhances Diagnostic Accuracy in Stable Coronary Artery Disease: A Comparative Study with Conventional CT" Journal of Clinical Medicine 14, no. 17: 6049. https://doi.org/10.3390/jcm14176049

APA Style

Nakashima, M., Miyoshi, T., Hara, S., Miyagi, R., Nishihara, T., Miki, T., Osawa, K., & Yuasa, S. (2025). Photon-Counting CT Enhances Diagnostic Accuracy in Stable Coronary Artery Disease: A Comparative Study with Conventional CT. Journal of Clinical Medicine, 14(17), 6049. https://doi.org/10.3390/jcm14176049

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Back to TopTop