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Ultra-High Resolution CT Imaging Improves Diagnosis of Coronary Artery Disease

By MedImaging International staff writers
Posted on 21 Jun 2023

Image: Ultra high-resolution coronary CT angiography in an 85-year-old man before transcatheter aortic valve replacement (Photo courtesy of University of Freiburg)

Coronary artery disease, the most prevalent type of heart disease, is effectively diagnosed in low to intermediate-risk patients using Coronary CT angiography (CCTA). However, applying CCTA to high-risk patients is challenging due to prevalent coronary calcifications and stents, which can appear overly extensive on CCTA, leading to overestimations of blockages and plaque, false positives, and potentially unnecessary invasive testing. As such, CCTA is not recommended for high-risk individuals according to current guidelines. However, ultra-high-resolution coronary CT angiography (UHR-CCTA), a relatively new tool utilizing photon-counting CT scanners, holds promise in noninvasively assessing high-risk patients for coronary artery disease.

Researchers at the University of Freiburg (Freiburg, Germany) have now discovered that UHR-CCTA provides high-quality imaging and accurate diagnoses in high-risk patients, thereby potentially broadening the patient pool for noninvasive screening. In their study, the research team compared the diagnostic accuracy of UHR-CCTA with invasive coronary angiography (ICA), the reference standard, in 68 patients suffering from severe aortic valve stenosis, a serious disease that impedes blood flow from the heart to the aorta. UHR-CCTA demonstrated high sensitivity and specificity in detecting coronary artery disease, with a median overall image quality score of 1.5 on the 5-point Likert scale, where 1 represents excellent and 5 signifies non-diagnostic. Nearly 80% of segments were deemed good or excellent, indicating the possibility of extending noninvasive imaging benefits to high-risk patients in the near future.

The higher resolution of UHR-CCTA is due to the increased number of emitted photons, which also results in higher radiation exposure compared to traditional CT scanners. Nevertheless, researchers point out that the technology is in its infancy, and strategies to lower radiation exposure are in development. While photon-counting CT is currently not widely used, it's expected to become more common over the next decade. The Freiburg researchers are now investigating the diagnostic potential of photon-counting CT in various other areas, such as oncological imaging, and are extending their research to patient subgroups for whom CT imaging is not currently viable, like those with coronary stents. Initial findings suggest that the technology could enhance soft tissue resolution, which would significantly aid in disease characterization.

"It appears that the spectrum of patients benefiting from undergoing non-invasive CCTA has been significantly broadened by photon-counting detector technology," said study lead author Muhammad T. Hagar, M.D., from the Department of Diagnostic and Interventional Radiology at the University of Freiburg. "This is excellent news for these patients and the imaging community."

Related Links:
University of Freiburg

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69 (43.153762817383): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=215 ORDER BY `ordering`

70 (!!!!! 2046.1082458496): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294797642 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (419.85511779785): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294797642 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (53.882598876953): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (302.07633972168): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (47.206878662109): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (91.075897216797): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (231.98127746582): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (298.02322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (!!!!! 5317.9264068604): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (163.79356384277): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (32.186508178711): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (!!!!! 4159.9273681641): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294797642 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (90.122222900391): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294797642 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (53.167343139648): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (265.12145996094): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (138.99803161621): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (128.03077697754): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (108.95729064941): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (126.12342834473): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (477.07557678223): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (152.1110534668): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (180.95970153809): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (121.11663818359): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (586.03286743164): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (183.8207244873): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (125.88500976562): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (288.00964355469): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (132.79914855957): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 3363.8477325439): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797642 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797642 AND published='1' LIMIT 1

105 (238.89541625977): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797642 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797642 AND published='1' LIMIT 1

106 (275.1350402832): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294797642 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (339.03121948242): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294797642 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 1205.9211730957): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797642 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797642 AND published='1' LIMIT 1

109 (79.870223999023): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797642 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797642 AND published='1' LIMIT 1

110 (74.148178100586): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294797642 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (736.95182800293): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294797642 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (730.99136352539): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (555.99212646484): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (171.18453979492): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797642 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797642 AND published='1' LIMIT 1

115 (72.002410888672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797642 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797642 AND published='1' LIMIT 1

116 (128.03077697754): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797642 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797642 AND published='1' LIMIT 1

117 (84.161758422852): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797642 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797642 AND published='1' LIMIT 1

118 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797642 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797642 AND published='1' LIMIT 1

119 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797642 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797642 AND published='1' LIMIT 1

120 (367.87986755371): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 25313.854217529): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

122 (144.95849609375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797642 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797642 AND published='1' LIMIT 1

123 (70.095062255859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797642 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797642 AND published='1' LIMIT 1

124 (504.0168762207): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294797642 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294797642 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 495694.16046143): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (123.97766113281): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (59.127807617188): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (41.007995605469): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (81.062316894531): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (41.961669921875): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (43.869018554688): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (38.14697265625): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (613.92784118652): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797642 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (464.91622924805): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797642 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (53.167343139648): SELECT name FROM jos_deeppockets WHERE id=215

136 (36.001205444336): SELECT name FROM jos_deeppockets WHERE id=215

137 (581.97975158691): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (505.92422485352): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (88.930130004883): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797642 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797642 AND published='1' LIMIT 1

140 (59.843063354492): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797642 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797642 AND published='1' LIMIT 1

141 (!!!!! 8657.9322814941): TRUNCATE TABLE jos_trademed_module

142 (96.797943115234): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294797642 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (54.836273193359): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294797642 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (805.13954162598): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797642 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797642 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (69.856643676758): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797642 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797642 AND published='1' LIMIT 1

147 (49.114227294922): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797642 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797642 AND published='1' LIMIT 1

148 (!!!!! 1446.008682251): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

149 (92.983245849609): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797642 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797642 AND published='1' LIMIT 1

150 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797642 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797642 AND published='1' LIMIT 1

151 (69.856643676758): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294797642 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294797642 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (57.220458984375): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

153 (46.968460083008): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

154 (56.028366088867): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (69.856643676758): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797642 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797642 AND published='1' LIMIT 1

156 (62.942504882812): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797642 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797642 AND published='1' LIMIT 1

157 (37.193298339844): select jos_twitters.link from jos_twitters where cat=10

158 (30.994415283203): select jos_facebook.link from jos_facebook where cat=10

159 (30.040740966797): select jos_google_plus.link from jos_google_plus where cat=10

160 (30.994415283203): select jos_linkedin.link from jos_linkedin where cat=10

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