Ultra-high-pitch photon-counting computed tomography (PCCT) versus ultra-high-pitch dual-source computed tomography (DSCT) for coronary artery disease evaluation in transcatheter aortic valve implantation (TAVI) patients

Rationale and objectives: To compare radiation dose and image quality of coronary artery reconstructions obtained from non–coronary-dedicated transcatheter aortic valve implantation (TAVI) planning CT scans using ultra-high-pitch photon-counting CT (PCCT) and ultra-high-pitch energy-integrating detector dual-source CT (EID-DSCT; hereafter referred to as DSCT), including assessment of the feasibility of coronary artery evaluation according to the Coronary Artery Disease Reporting and Data System (CAD-RADS).

Materials and methods

Retrospective study on consecutive patients with aortic valve stenosis (AS) undergoing contrast-enhanced TAVI planning CT, either PCCT or DSCT between August 2021 and June 2023. CT dose index (CTDI) and dose length product (DLP) were used to calculate the effective radiation dose (eRD). Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated using standardized region-of-interest (ROI) analysis. Coronary arteries were evaluated by three independent radiologists using 5-point Likert scales followed by a classification according to the CAD-RADS system.