Diagnostic Performance and Clinical Impact of Photon-Counting Detector Computed Tomography in Coronary Artery Disease
Authors' conclusion
PCD-CT exhibited excellent diagnostic performance for detecting obstructive CAD. Compared with patients undergoing conventional EID-CT, fewer patients were referred to ICA after PCD-CT, but those referred were more likely to undergo revascularization.
Study context
- Population
- Consecutive patients undergoing clinically indicated coronary CT angiography at a single centre, 2022–2023vessel-level analysis n = 1,686
- Participants
- 7,833 patients
- Exposure
- Photon-counting detector-computed tomography (PCD-CT) vs conventional energy-integrating detector computed tomography (EID-CT) for coronary computed tomography angiography (CCTA)
- Outcome
- Diagnostic performance for obstructive CAD (≥50% diameter stenosis on quantitative coronary angiography as reference) and clinical impact (ICA referral, revascularization)
Methodological detailssingle-centre, consecutive patients, blinded assessment
- Single-centre
- Consecutive patients
- Blinded assessment
Main finding
As reported in the abstract
- Referral to invasive coronary angiography (ICA) after CCTA, PCD-CT vs EID-CT
- 9.9% vs 13.1%; P < 0.001
- Revascularization among those undergoing ICA, PCD-CT vs EID-CT
- 43.4% vs 35.5%; P = 0.02
- Specificity for obstructive coronary artery disease (CAD), PCD-CT vs EID-CT (vessel level)
- 98.0% vs 93.0%; P < 0.001
- PPV for obstructive CAD, PCD-CT vs EID-CT (vessel level)
- 83.3% vs 63.0%; P = 0.002
- Diagnostic accuracy for obstructive CAD, PCD-CT vs EID-CT (vessel level)
- 97.2% vs 92.8%; P < 0.001
- Sensitivity for obstructive CAD, PCD-CT vs EID-CT (vessel level)
- 90.9% vs 90.7%; P = 0.95
- NPV for obstructive CAD, PCD-CT vs EID-CT (vessel level)
- 98.9% vs 98.7%; P = 0.83
Observational data: associations, not effects.
Further findings
Referral to ICA
P < 0.001
Revascularization among those undergoing ICA
P = 0.02
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Diagnostic Performance and Clinical Impact of Photon-Counting Detector Computed Tomography in Coronary Artery Disease. J Am Coll Cardiol. Published 28 October 2024. doi:10.
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