Coronary Calcium Scoring with First Generation Dual-Source Photon-Counting CT—First Evidence from Phantom and In-Vivo Scans

We evaluated the accuracy of coronary artery calcium (CAC) scoring on a dual-source photon-counting detector CT (PCD-CT). An anthropomorphic chest phantom underwent ECG-gated sequential scanning PCD-CT at 120 kV with four radiation dose levels (CTDIvol, 2.0–8.6 mGy). Polychromatic images (T3D) and virtual monoenergetic (VMI), from 60 to 75 keV without quantum iterative reconstruction (no QIR) QIR strength 1–4, were reconstructed. For reference, same was scanned conventional energy-integrating (120 kV; filtered back projection) identical doses. CAC in 20 patients no 1–4) included. In phantom, there differences between scores different doses (all, p > 0.05). Images 70 keV, (CAC score, 649); 65 3 (656); keV; QIR4 (648) T3D, (656) showed <1% deviation reference (653). significantly decreased increasing < 0.001) for each 5 keV-increase 0.001). Patient data (median score: 86 [inter-quartile range: 38–978] keV) confirmed relationships reconstructions phantom. First in-vivo experience clinical system shows accurate VMI levels.