The advent of photon-counting CT (PCCT) signifies a paradigm shift in cardiovascular imaging, as eloquently reviewed by Cademartiri et al in their recent comprehensive systematic review in our current issue.1 Cardiac CT has become a cornerstone of modern cardiology over the past decade, with robust data from multiple randomised trials supporting its use in primary prevention via coronary artery calcium scoring and in evaluating stable angina and acute chest pain. Current guidelines now endorse cardiac CT with a Class Ia recommendation.2 Despite these achievements, conventional CT technology remains constrained in scenarios involving heavy calcifications, prior stents and the growing clinical imperative for lower radiation doses and enhanced spatial resolution. Where do we go from here? The next frontier is PCCT.
PCCT represents an evolution beyond conventional CT, driven by the introduction of unique photon-counting detectors. These detectors directly convert X-ray photons into electrical signals, resulting in improved energy resolution, reduced electronic noise and superior spatial resolution. These technological advancements effectively address several inherent limitations of traditional CT systems. One of the other key benefits of PCCT is its ability to perform K-edge imaging, which allows the use of non-iodine contrast agents expanding its …
