The Role Of Photon-Counting Detector CT In Quantifying Coronary Plaque Composition: A Comparative Study With Intravascular Ultrasound

Abstract

Photon-counting detector computed tomography (PCD-CT) represents a revolutionary advancement in cardiac imaging, tissue characterization capabilities compared to conventional energy-integrating detector CT and offering superior spatial resolution and This study evaluates the accuracy of PCD-CT in quantifying coronary plaque composition using intravascular ultrasound (IVUS) as a standard.  156 patients with suspected coronary artery disease who underwent both PCD-CT coronary angiography and IVUS examination between January 2022 and December 2023. Analyzed Coronary plaques were   calcifiednon-calcified ,composition including  and mixed components. Statistical analysis included correlation coefficients, receiver operating characteristic curves and Bland-Altman analysis Non-calcified plaque identification achieved sensitivity of 87.5% and specificity of 89.3%.  For calcified plaque detection, PCD-CT showed sensitivity of 94.2% and specificity of 91.8%. The mean difference in total plaque volume between PCD-CT and IVUS was 2.3 ± 8.7 mm³.PCD-CT demonstrated excellent correlation with IVUS for plaque volume quantification (r = 0.89, p < 0.001).   PCD-CT provides highly accurate quantification of coronary plaque composition with excellent agreement to IVUS. This technology offers significant potential for non-invasive coronary plaque characterization and risk stratification.