PhD Scientific Days 2025

Poster Session I. - T: Cardiovascular Medicine and Research

Single-Source versus Dual-Source Photon Counting-Detector in Coronary CT Angiography: Initial Experience and Image Quality

Name of the presenter

Beke Sámuel

Institute/workplace of the presenter

Semmelweis University, Medical Imaging Centre

Authors

Sámuel Beke¹, Lili Száraz¹, Bálint Tamás², Attila Fülöp³, Kristóf Nagy¹, Barnabás Baksa¹, Emese Zsarnóczay¹, Bálint Szilveszter⁴, Béla Merkely⁴, Pál Maurovich-Horvat¹

1: Semmelweis University, Medical Imaging Centre
2: University of Zurich, Brain Research Institute
3: Budapest University of Technology and Economics
4: Semmelweis University, Heart and Vascular Center

Text of the abstract

Introduction: Single X-ray tube and detector system may influence temporal resolution and noise characteristics compared to dual-source (DuS) systems.

Aim: This study evaluates the impact of DuS photon-counting detector CT (PCD-CT) compared to single-source (SiS) PCD-CT on both objective and subjective image quality (IQ) parameters using standard resolution scan modes in coronary CT angiography (CCTA) examinations.

Method: For SiS group, consecutive patients who were referred to clinically indicated CCTA examination were prospectively enrolled, while DuS group patients were selected from our institutional cardiac CT registry matched for sex, age, heart rate, BMI, coronary dominance, and acquisition settings. Objective parameters: image noise (IN), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and vessel sharpness were measured by a single reader. Subjective IQ and motion artifacts were assessed per-patient, per-vessel and per-segment, graded on a 4-point Likert scale by one reader (1: non-diagnostic, 2: severe artifacts, 3: mild artifacts, 4: no artifacts).

Results: A total of 108 patients and 1395 coronary segments were evaluated. No significant differences were observed in anthropometric data or cardiovascular risk factors between the groups. The DuS group had a significantly higher mean dose-length product (267.03±156.50 vs. 146.26±59.63 mGy·cm, p<0.005) and effective dose (4.46±2.58 vs. 2.53±0.89 mSv, p<0.005). Objective IQ parameters showed no significant differences between DuS and SiS scanners for IN (32.8±6.2 vs. 31.6±9.8), SNR (22.1±4.2 vs. 23.8±4.5), CNR (24.9±4.3 vs. 27.1±5.3), or vessel sharpness (489.7±76.4 vs. 490.1±77.3, all p>0.005). However, DuS-CT demonstrated superior subjective IQ on a per-patient (3.69±0.22 vs. 3.35±0.35, p<0.005), per-vessel (LM-LAD: 3.67±0.24 vs. 3.43±0.36; RCA: 3.7±0.27 vs. 3.27±0.32; LCx: 3.60±0.50 vs. 3.22±0.58; all p<0.005), and distal segment level (3.62±0.24 vs. 3.21±0.40, p<0.005). Image interpretability was significantly better with DuS-CT on a per-patient basis (96.3% vs. 85.2%, p<0.005).

Conclusion: DuS PCD-CT did not significantly improve objective IQ compared to SiS PCD-CT in standard resolution modes. However, it provided better subjective IQ and interpretability at patient, vessel, and segment levels, potentially enhancing diagnostic confidence in CCTA despite higher radiation exposure.