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Background <p>For patients with aortic diseases, coronary CT angiography (CCTA) is performed for preoperative evaluation of coronary artery disease, often in combination with CT angiography of thoracic and abdominal aorta (CTAO) within the same examination. A dual-source photon-counting detector CT (PCD-CT) offers advantages including improved dose efficiency and reduction of electronic noise, which might help maintain image quality even at low tube voltages. This study aimed to compare a low-kV one-scan CCTA/CTAO protocol with a low-kV dedicated CCTA followed by a higher-kV CTAO acquisition (separate-scan) regarding radiation dose and image quality.</p> Methods <p>This retrospective, single-center study included 42 patients who underwent CCTA and CTAO using PCD-CT for preoperative CAD screening for aortic disease: 19 had separate-scan, 23 had one-scan CCTA and CTAO. Image quality for CCTA was assessed using a four-point scale (excellent, good, fair, non-diagnostic). Image quality for CTAO was assessed using a five-point scale (excellent, good, moderate, poor, non-diagnostic).</p> Results <p>Radiation dose was significantly lower in the one-scan group compared to the separate-scan group (mean total dose-length product, 175.8 ± 71.1 vs. 769.4 ± 212.1 mGy·cm; <i>P</i> &lt; 0.001). For CCTA, subjective image quality scores were comparable between the two groups (<i>P</i> = 0.537), although the separate-scan group showed significantly higher objective CNR compared to the one-scan group (<i>P</i> =0.025). For CTAO, the subjective image quality was significantly superior in the one-scan group (<i>P</i> &lt; 0.01), despite comparable CNR between the groups (<i>P</i> = 0.13). The proportions of good or excellent ratings were 97.1% and 98.4% for CCTA, and 85.1% and 91.3% for CTAO in the separate-scan and one-scan groups, respectively.</p> Conclusions <p>The low-kV one-scan strategy using PCD-CT substantially reduced radiation dose while maintaining comparable subjective CCTA quality and superior subjective CTAO quality. This approach may provide a dose-efficient option in selected patients requiring primary aortic assessment with concomitant coronary screening; however, its adequacy for preoperative CAD screening remains to be established.</p>

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Low-kV high-pitch one-scan aortic and coronary CT angiography using dual-source photon-counting CT: comparison with separate acquisition strategies

  • 期刊论文

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  • 发表日期：

    2026年7月31日

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  • Hiroaki Kato,
  • Suguru Araki,
  • Satoshi Nakamura,
  • Takafumi Ouchi,
  • Akio Yamazaki,
  • Takatoshi Higashigawa,
  • Noriyuki Kato,
  • Yasutaka Ichikawa,
  • Hajime Sakuma,
  • Kakuya Kitagawa

摘要

Background

For patients with aortic diseases, coronary CT angiography (CCTA) is performed for preoperative evaluation of coronary artery disease, often in combination with CT angiography of thoracic and abdominal aorta (CTAO) within the same examination. A dual-source photon-counting detector CT (PCD-CT) offers advantages including improved dose efficiency and reduction of electronic noise, which might help maintain image quality even at low tube voltages. This study aimed to compare a low-kV one-scan CCTA/CTAO protocol with a low-kV dedicated CCTA followed by a higher-kV CTAO acquisition (separate-scan) regarding radiation dose and image quality.

Methods

This retrospective, single-center study included 42 patients who underwent CCTA and CTAO using PCD-CT for preoperative CAD screening for aortic disease: 19 had separate-scan, 23 had one-scan CCTA and CTAO. Image quality for CCTA was assessed using a four-point scale (excellent, good, fair, non-diagnostic). Image quality for CTAO was assessed using a five-point scale (excellent, good, moderate, poor, non-diagnostic).

Results

Radiation dose was significantly lower in the one-scan group compared to the separate-scan group (mean total dose-length product, 175.8 ± 71.1 vs. 769.4 ± 212.1 mGy·cm; P < 0.001). For CCTA, subjective image quality scores were comparable between the two groups (P = 0.537), although the separate-scan group showed significantly higher objective CNR compared to the one-scan group (P =0.025). For CTAO, the subjective image quality was significantly superior in the one-scan group (P < 0.01), despite comparable CNR between the groups (P = 0.13). The proportions of good or excellent ratings were 97.1% and 98.4% for CCTA, and 85.1% and 91.3% for CTAO in the separate-scan and one-scan groups, respectively.

Conclusions

The low-kV one-scan strategy using PCD-CT substantially reduced radiation dose while maintaining comparable subjective CCTA quality and superior subjective CTAO quality. This approach may provide a dose-efficient option in selected patients requiring primary aortic assessment with concomitant coronary screening; however, its adequacy for preoperative CAD screening remains to be established.