Photon counting CT is superior to conventional CT in characterizing the true degree of carotid stenosis

In the case of carotid artery disease, improved evaluation of plaque morphology and better characterization of stenotic disease, particularly highly calcific or heterogenous lesions, is extremely important in making appropriate patient care decisions in the treatment of both symptomatic and asymptomatic disease. We present three cases here wherein repeating a CT angiogram with higher quality, photon-counting detector CT resulted in a more accurate measured degree of stenosis, more appropriate patient counseling, and a change in clinical management.