Assessing internal carotid artery stenosis: Diagnostic Value of photon-counting detector CT angiography compared to Doppler ultrasound.

Objectives: To evaluate the diagnostic accuracy of photon-counting detector CT angiography (PCD-CTA) for grading internal carotid artery (ICA) stenosis compared to color Doppler ultrasonography (CDUS).

Methods: In this study, patients underwent both contrast-enhanced PCD-CTA and CDUS within six months. Four board-certified radiologists graded ICA stenosis using the North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria (grades 1-5) through visual and measurement-based methods from PCD-CTA.

Predicting MRI-diagnosed microvascular obstruction and its long-term impact after acute myocardial infarction.

Background: Microvascular obstruction (MVO) at cardiac magnetic resonance imaging (CMR) is a well-described risk factor for cardiac events after acute myocardial infarction (MI).

Objective: Predicting MVO using cardiac biomarkers and performing risk stratification according to extent of MVO.

Methods: We conducted a retrospective study including all patients with an acute MI and a subsequent CMR during the same hospital stay between October 2008 and August 2023.

Ultra-high-resolution and dual-energy computed tomography of carotid artery plaques differentiate symptomatic and asymptomatic patients by novel volumetric analysis.

Objectives: The indication for carotid endarterectomy (CEA) mainly relies on the degree of stenosis and neurological symptoms. Plaque vulnerability has been associated with stroke risk, but identification on single-energy computed tomography (CT) has yielded heterogeneous results and is not routinely applied to clinical diagnostics. Hence, we intended to analyse CEA specimens for vulnerability features using dual-source CT and correlate these features with the presence of preprocedural symptoms.

CT-based evaluation of patient-prosthesis mismatch after transcatheter aortic valve implantation and its influence on outcome.

Background: Patient-prosthesis mismatch (PPM) after trans-catheter aortic valve implantation (TAVI) is a risk factor for heart failure and mortality. Assessment of PPM using transthoracic echocardiography (TTE) and presence of hypo-attenuated leaflet thickening (HALT) may lead to overestimation. Our study aimed to assess the incidence of PPM using TTE and CTA after exclusion of patients with HALT and to evaluate predictors analyzing stent geometry.

Performance of large language models for CAD-RADS 2.0 classification derived from cardiac CT reports.

Background: The Coronary Artery Disease-Reporting and Data System (CAD-RADS) 2.0 offers standardized guidelines for interpreting coronary artery disease in cardiac CT. Accurate and consistent CAD-RADS 2.

Influence of Prosthesis Position on Pacing Burden and Long-Term Survival in TAVI Patients with New Pacemaker.

The aim of this study was to evaluate the influence of three-dimensional transcatheter heart valve (THV) position on mid-term pacing burdens and to examine the effect of stimulation rates on survival after transcatheter aortic valve implantation (TAVI). In patients receiving a new PPM before discharge after TAVI, we analyzed the final three-dimensional THV position in 107 patients (78 with Sapien S3 THV and 29 with Evolut R THV) using fusion imaging from pre- and post-TAVI computed tomography angiography. The PPM stimulation rates were examined pre-discharge and after 3 months.

Feasibility of very low iodine dose aortoiliac CT angiography using dual-source photon-counting detector CT.

Purpose: To evaluate the feasibility of aortoiliac CT-Angiography (CTA) using dual-source photon-counting detector (PCD)-CT with minimal iodine dose.

Methods: This IRB-approved, single-center prospective study enrolled patients with indications for aortoiliac CTA from December 2022 to March 2023. All scans were performed using a first-generation dual-source PCD-CT.

Fully Automated Assessment of Cardiac Chamber Volumes and Myocardial Mass on Non-Contrast Chest CT with a Deep Learning Model: Validation Against Cardiac MR.

: To validate the automated quantification of cardiac chamber volumes and myocardial mass on non-contrast chest CT using cardiac MR (CMR) as a reference. : We retrospectively included 53 consecutive patients who received non-contrast chest CT and CMR within three weeks. A deep learning model created cardiac segmentations on axial soft-tissue reconstructions from CT, covering all four cardiac chambers and the left ventricular myocardium.

Evaluating small coronary stents with dual-source photon-counting computed tomography: effect of different scan modes on image quality and performance in a phantom.

Purpose: The study aimed to assess the feasibility and image quality of dual-source photon-counting detector computed tomography (PCD-CT) in evaluating small-sized coronary artery stents with respect to different acquisition modes in a phantom model.

Methods: Utilizing a phantom setup mimicking the average patient's water-equivalent diameter, we examined six distinct coronary stents inflated in a silicon tube, with stent sizes ranging from 2.0 to 3.

Correlation of greyzone fibrosis compared to troponin T and late gadolinium enhancement with survival and ejection fraction in patients after acute myocardial infarction.

Aims: To quantify greyzone fibrosis (GZF) in patients after acute myocardial infarction (MI) and to evaluate its correlation with MI-free survival and improvements in left ventricular ejection fraction (LVEF) compared with the established risk factors high-sensitivity cardiac troponin T (hs-cTnT) and Late Gadolinium Enhancement (LGE).

Methods And Results: The study involved 176 patients who experienced acute MI and underwent cardiac magnetic resonance (CMR) prior to hospital discharge, followed by a second CMR on average six months later. LGE was quantified in both examinations, a separate analysis of the GZF was conducted only in the follow-up CMR after resolution of the initial infarct edema.

CT Myocardial Perfusion and CT-FFR versus Invasive FFR for Hemodynamic Relevance of Coronary Artery Disease.

Background CT-derived fractional flow reserve (CT-FFR) and dynamic CT myocardial perfusion imaging enhance the specificity of coronary CT angiography (CCTA) for ruling out coronary artery disease (CAD). However, evidence on comparative diagnostic value remains scarce. Purpose To compare the diagnostic accuracy of CCTA plus CT-FFR, CCTA plus CT perfusion, and sequential CCTA plus CT-FFR and CT perfusion for detecting hemodynamically relevant CAD with that of invasive angiography.

Accuracy of a deep learning-based algorithm for the detection of thoracic aortic calcifications in chest computed tomography and cardiovascular surgery planning.

Objectives: To assess the accuracy of a deep learning-based algorithm for fully automated detection of thoracic aortic calcifications in chest computed tomography (CT) with a focus on the aortic clamping zone.

Methods: We retrospectively included 100 chest CT scans from 91 patients who were examined on second- or third-generation dual-source scanners. Subsamples comprised 47 scans with an electrocardiogram-gated aortic angiography and 53 unenhanced scans.

Quantification of Aortic Valve Calcification in Contrast-Enhanced Computed Tomography.

: The goal of our study is to evaluate a method to quantify aortic valve calcification (AVC) in contrast-enhanced computed tomography for patients with suspected severe aortic stenosis pre-interventionally. : A total of sixty-five patients with aortic stenosis underwent both a native and a contrast-enhanced computed tomography (CECT) scan of the aortic valve (45 in the training cohort and 20 in the validation cohort) using a standardized protocol. Aortic valve calcification was semi-automatically quantified via the Agatston score method for the native scans and was used as a reference.

Ultrashort VIBE-Dixon versus Cine and late gadolinium enhancement MRI sequences for cardiac thrombus detection.

Purpose: To determine the diagnostic accuracy of volumetric interpolated breath-hold examination sequences with fat suppression in Dixon technique (VIBE-Dixon) for cardiac thrombus detection.

Method: From our clinical database, we retrospectively identified consecutive patients between 2014 and 2022 who had definite diagnosis or exclusion of cardiac thrombus confirmed by an independent adjudication committee, serving as the reference standard. All patients received 2D-Cine plus 2D-Late-Gadolinium-Enhancement (Cine + LGE) and VIBE-Dixon sequences.

Ultra-high-resolution photon-counting detector CT in evaluating coronary stent patency: a comparison to invasive coronary angiography.

Objectives: To determine the diagnostic accuracy of ultra-high-resolution photon-counting detector CT angiography (UHR PCD-CTA) for evaluating coronary stent patency compared to invasive coronary angiography (ICA).

Methods: Consecutive, clinically referred patients with prior coronary stent implantation were prospectively enrolled between August 2022 and March 2023 and underwent UHR PCD-CTA (collimation, 120 × 0.2 mm).

Photon-counting computed tomography - clinical application in oncological, cardiovascular, and pediatric radiology.

Background: Photon-counting detector computed tomography (PCD-CT) is a promising new technology with the potential to fundamentally change workflows in the daily routine and provide new quantitative imaging information to improve clinical decision-making and patient management.

Method: The contents of this review are based on an unrestricted literature search of PubMed and Google Scholar using the search terms "photon-counting CT", "photon-counting detector", "spectral CT", "computed tomography" as well as on the authors' own experience.

Results: The fundamental difference with respect to the currently established energy-integrating CT detectors is that PCD-CT allows for the counting of every single photon at the detector level.

Investigation of factors determining haemodynamic relevance of leaflet thrombosis after transcatheter aortic valve implantation.

Aims: To determine the conditions under which early hypoattenuated leaflet thickening (HALT) after transcatheter aortic valve implantation (TAVI) becomes haemodynamically relevant.

Methods And Results: The study included 100 patients (age: 81.5 ± 5.

Enhancing Radiation Dose Efficiency in Prospective ECG-Triggered Coronary CT Angiography Using Calcium-Scoring CT.

Background: This study investigates whether the scan length adjustment of prospectively ECG-triggered coronary CT angiography (CCTA) using calcium-scoring CT (CAS-CT) images can reduce overall radiation doses.

Methods: A retrospective analysis was conducted on 182 patients who underwent CAS-CT and prospectively ECG-triggered CCTA using a second-generation Dual-Source CT scanner. CCTA planning was based on CAS-CT images, for which simulated scout view planning was performed for comparison.

Accuracy of Ultrahigh-Resolution Photon-counting CT for Detecting Coronary Artery Disease in a High-Risk Population.

Background Recently introduced photon-counting CT may improve noninvasive assessment of patients with high risk for coronary artery disease (CAD). Purpose To determine the diagnostic accuracy of ultrahigh-resolution (UHR) coronary CT angiography (CCTA) in the detection of CAD compared with the reference standard of invasive coronary angiography (ICA). Materials and Methods In this prospective study, participants with severe aortic valve stenosis and clinically indicated CT for transcatheter aortic valve replacement planning were consecutively enrolled from August 2022 to February 2023.

Spectral aortoiliac photon-counting CT angiography with minimal quantity of contrast agent.

The incidence of vascular and especially aortic pathologies is increasing, which leads to a higher frequency of vascular imaging. As renal pathologies also become more frequent, especially in an aging population, the need for effective preventative scan protocols with reduced contrast material is pressing. An 81-year-old female patient in our institution required a follow-up imaging of an incidental, asymptomatic abdominal aortic aneurysm.

Structured Reporting in Cross-Sectional Imaging of the Heart: Reporting Templates for CMR Imaging of Ischemia and Myocardial Viability and for Cardiac CT Imaging of Coronary Heart Disease and TAVI Planning.

Background: Structured reporting allows a high grade of standardization and thus a safe and unequivocal report communication. In the past years, the radiological societies have started several initiatives to base radiological reports on structured reporting rather than free text reporting.

Methods: Upon invitation of the working group for Cardiovascular Imaging of the German Society of Radiology, in 2018 an interdisciplinary group of Radiologists, Cardiologists, Pediatric Cardiologists and Cardiothoracic surgeons -all experts on the field of cardiovascular MR and CT imaging- met for interdisciplinary consensus meetings at the University Hospital Cologne.