Value of Ultra-High-Resolution Photon-Counting Computed Tomography in Cardiovascular Imaging
Main Article Content
Abstract
Photon-counting computed tomography with ultra-high-resolution imaging represents an important advance in cardiovascular imaging through direct conversion of individual X-ray photons, smaller detector elements, and intrinsic multi-energy data. This focused narrative review analyzes the technical basis, clinical evidence, and patient selection for ultra-high-resolution coronary CT angiography. Literature was searched in PubMed/MEDLINE and official journal websites through August 14, 2026, prioritizing recent intraindividual comparisons, studies using invasive coronary angiography as reference, and clinically relevant reports. Available evidence indicates reduced calcium- and stent-related blooming, improved stenosis quantification, better visualization of the in-stent lumen, and greater reproducibility of plaque measurements. However, very thin sections increase image noise, data volume, reconstruction demand, and sensitivity to cardiac motion; routine use in every patient is therefore not justified. Current clinical value is greatest in severe coronary calcification, prior stent implantation, small vessels, and otherwise indeterminate conventional examinations. Multicenter outcome studies, dose optimization, standardized plaque thresholds, and validated artificial-intelligence tools remain priorities for future research.
Keywords: photon-counting computed tomography; ultra-high resolution; coronary artery; stent; atherosclerotic plaque.
Keywords
photon-counting computed tomography, ultra-high resolution, coronary artery, stent, atherosclerotic plaque
Article Details
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