Abstract
Abstract
Objectives
To assess the diagnostic performance of photon-counting computed tomography (PCCT) coronary angiography for the detection of in-stent restenosis (ISR) ≥ 50%, and image quality.
Materials and methods
141 consecutive patients with coronary stents referred to coronary computed tomography angiography (CTA) were enrolled in this retrospective single-center study, using either PCCT or energy-integrating detector (EID)-CT. Image quality of the in-stent lumen (ISL) was graded using a 3-point scale as 2 = “excellent diagnostic”, 1 = “limited diagnostic”, or 0 = nondiagnostic. Coronary stents were assessed for ISR ≥ 50% compared to invasive coronary angiography (ICA), and quantitative image analysis was performed.
Results
176 stents in 70 patients (age 73.64 ± 12.6, 27.1% women) who underwent PCCT were included and compared to a control group of 71 patients (126 stents) who underwent EID-CT. Subjective image quality scores were higher in stents assessed by PCCT compared with EID-CT (
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Conclusions
Image quality of PCCT for coronary stent evaluation is improved compared to EID-CT, and the accuracy for detection of ISR ≥ 50% is high.
Key Points
Question
Does photon-counting CT improve the diagnostic accuracy for detection of in-stent restenosis (ISR) ≥ 50%, and image quality compared with energy-integrating detector (EID) CT?
Findings
Photon-counting CT provides higher image quality and a low rate of nondiagnostic stents (0.3%). For detecting ≥ 50% ISR, the diagnostic accuracy is high and the PPV is moderate
.
Clinical relevance
Photon-counting computed tomography (PCCT) has the potential to overcome technical limitations of conventional energy-integrating CT in coronary stent assessment and could improve the reliability of non-invasive follow-up after percutaneous coronary intervention
.