What question did this study set out to answer?

To assess how varying CT section thickness affects the quantification of aortic valve calcification.

March 28, 2026

Effect of CT Section Thickness on Aortic Valve Calcium Scoring via Photon-counting Detector CT

Resultado clave

Thin-section photon-counting detector CT decreased aortic valve Agatston scores compared to 3-mm sections, reclassifying aortic stenosis severity in 8.3% to 9.5% of patients.

Puntos clave

To assess how varying CT section thickness affects the quantification of aortic valve calcification.
Included patients who underwent electrocardiography-gated photon-counting detector CT.
Measured aortic valve Agatston score, calcium volume, and calcium mass at three section thicknesses: 3-mm, 1-mm, and 0.4-mm.
Applied linear mixed model and regression analyses to classify aortic stenosis severity.
AVAS and AVCV decreased with thinner sections, impacting aortic stenosis severity classification in 8%-9% of patients.
Identified regression-based thresholds for AVAS in male and female patients at varying section thicknesses.

PICO estructurado

Does thin-section photon-counting detector CT alter aortic valve calcium scoring and severity classification compared to standard 3-mm sections in patients undergoing cardiac CT?

Población

Patients who underwent electrocardiography-gated photon-counting detector (PCD) CT

Intervención

Thin-section (1-mm and 0.4-mm) CT reconstruction

Comparador

Standard 3-mm section CT reconstruction

Resultado

Aortic valve Agatston score (AVAS), aortic valve calcium volume (AVCV), and aortic valve calcium mass (AVCM)surrogate

Using thinner CT sections (1-mm or 0.4-mm) for aortic valve calcium scoring significantly lowers Agatston scores and volumes, potentially reclassifying nearly 10% of patients from severe to nonsevere aortic stenosis if standard thresholds are used.

Resultado numérico

Tasa de eventos absoluta: 0% vs 0%

Resumen

Purpose To evaluate the effect of section thickness on aortic valve calcification quantification via photon-counting detector (PCD) CT. Materials and Methods This retrospective study included patients who underwent electrocardiography-gated PCD CT from March 2023 to October 2024. The aortic valve Agatston score (AVAS), aortic valve calcium volume (AVCV), and aortic valve calcium mass (AVCM) were measured at 3-mm, 1-mm, and 0.4-mm sections. Linear mixed model and regression analyses were performed. Sex-specific AVAS thresholds were used for aortic stenosis (AS) severity classification (≥2000 for male patients, ≥1300 for female patients). Results Eighty-four patients (median age: 84 years IQR: 80-88 years, 58 female) were included. AVAS at 70 keV decreased with thinner sections: 3-mm section, 2141 (95% CI: 1931, 2351); 1-mm section, 1900 (95% CI: 1690, 2110), and 0.4-mm section, 1791 (95% CI: 1581, 2001) (P 3 (95% CI: 1640, 1972), 1496 mm3 (95% CI: 1330, 1661), and 1373 mm3 (95% CI: 1207, 1538) (P P P = .24). Compared with 3-mm sections, seven of 84 (8.3%) and eight of 84 (9.5%) patients were reclassified from CT-severe to CT-nonsevere with 1- and 0.4-mm sections, respectively (P Keywords: Applications-CT, CT-Photon Counting, Cardiac, Aortic Valve, Calcifications/Calculi Supplemental material is available for this article. © RSNA, 2026.

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