Background Photon-counting detector computed tomography (PCD-CT) is an emerging technology that improves dose efficiency, image resolution, and noise performance. We aimed to compare the safety and effectiveness of the first-generation PCD-CT with a third-generation energy-integrating detector computed tomography (EID-CT) for the detection of coronary artery disease in the participants from a health check programme in Taiwan. Methods In this retrospective, single-centre study, we included 205 asymptomatic individuals undergoing coronary computed tomography angiography as part of their health screening: 103 with EID-CT in July 2024 and 102 with PCD-CT in January 2025. All scans were acquired using the helical mode. Radiation exposure, iodinated contrast volume, and referral outcomes were compared between those scanned with PCD-CT and with EID-CT. Results Baseline characteristics were generally balanced between the two groups except for height, smoking habit, and plasma lipid and glucose concentrations. The PCD-CT group had a lower radiation dose indexed by dose length product (401.0 vs. 633.6 mGy·cm and 421.5 vs. 690.0 mGy·cm for the main scan and for the total procedure, respectively; both P 0.999). Conclusions The first-generation PCD-CT, compared with a third-generation EID-CT, offered a substantial reduction in radiation exposure without additional needs for invasive cardiac catheterisation. Further studies using contrast-optimisation technologies and dose-optimisation strategies are warranted to assess diagnostic quality.
Lu et al. (Mon,) studied this question.
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