Comparison of photon-counting CT angiography with energy-integrating CT angiography in coronary artery stenosis: a systematic review and meta-analysis
Abstract
Purpose: To perform CT-angiography of coronary arteries, energy-integrating detector computed tomography (EID-CT) is widely used but it has several limitations, especially in overestimation of size of calcium plaques. Photon-counting detector computed tomography (PCD-CT) promises better image quality and lower radiation. This study compares the efficacy, radiation dose, and image quality of EID-CT and PCD-CT for coronary artery disease (CAD) diagnosis.
Materials and methods: A systematic review and meta-analysis were conducted per PRISMA guidelines. Four databases were searched for studies directly comparing EID-CT and PCD-CT. Data on coronary artery calcium scores (CACS), radiation dose index (mGy), dose-length product (DLP), and image quality were extracted. Risk of bias was assessed using the QUADAS-C tool.
Results: Twelve studies with 213 patients were included. PCD-CT showed a significant reduction in dose index (standardized mean difference (SMD) = -0.62, 95% CI: -0.89 to -0.35, p < 0.001) and DLP (SMD = -0.66, 95% CI: -0.98 to -0.35, p < 0.001) compared to EID-CT. Quantitative data for image quality and artifacts was limited, but qualitative assessments indicated PCD-CT's superior performance in reducing beam-hardening artifacts and providing clearer images of calcified plaques. No significant difference was found in CACS between the modalities (intraclass correlation coefficient (ICC) = 0.992, 95% CI: 0.981 to 1.000) based on individual patient data. PCD-CT results…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 213 participants or records.
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