Low-kV high-pitch one-scan aortic and coronary CT angiography using dual-source photon-counting CT: comparison with separate acquisition strategies.
4 affiliations
- 1Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
- 2Department of Advanced Diagnostic Imaging, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan. [email protected].
- 3Department of Advanced Diagnostic Imaging, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
- 4MUDX Initiative, Mie University Organization for Research Initiative and Promotion, 1577 Kurimamachiyacho, Tsu, Mie, 514-8507, Japan.
Abstract
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.
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BibTeX
@article{kato2026lowkv,
title = {{Low-kV high-pitch one-scan aortic and coronary CT angiography using dual-source photon-counting CT: comparison with separate acquisition strategies.}},
author = {Hiroaki Kato and Suguru Araki and Satoshi Nakamura and Takafumi Ouchi and Akio Yamazaki and Takatoshi Higashigawa and Noriyuki Kato and Yasutaka Ichikawa and Hajime Sakuma and Kakuya Kitagawa},
journal = {BMC medical imaging},
year = {2026},
month = jul,
doi = {10.1186/s12880-026-02629-0},
url = {https://europepmc.org/article/MED/42972287},
note = {CC BY},
}
RIS
TY - JOUR
TI - Low-kV high-pitch one-scan aortic and coronary CT angiography using dual-source photon-counting CT: comparison with separate acquisition strategies.
AU - Hiroaki Kato
AU - Suguru Araki
AU - Satoshi Nakamura
AU - Takafumi Ouchi
AU - Akio Yamazaki
AU - Takatoshi Higashigawa
AU - Noriyuki Kato
AU - Yasutaka Ichikawa
AU - Hajime Sakuma
AU - Kakuya Kitagawa
PY - 2026
DA - 2026/07/31
JO - BMC medical imaging
DO - 10.1186/s12880-026-02629-0
UR - https://europepmc.org/article/MED/42972287
AB - 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.
SN - 1471-2342
ER -