{"doi":"10.1002/mp.16712","title":"Technical note: Exploring the detectability of coronary calcification using ultra‐high‐resolution photon‐counting‐detector CT","abstract":"BACKGROUND: Coronary calcification is a strong indicator of coronary artery disease, and patients with a \"zero\" coronary calcification score have a much lower risk of future cardiac events than those with even small amounts of calcium. However, false-negative (incorrect zero scores) may occur if small calcifications are missed at CT due to limited spatial resolution. PURPOSE: To demonstrate lower limits of detection for coronary calcification using an ultra-high-resolution (UHR) mode on a clinical photon-counting-detector CT (PCD-CT), compared to a conventional energy-integrating-detector CT (EID-CT). METHODS: Chicken eggshell fragments (0.4-0.8 mm) mimicking coronary calcifications were scanned on a clinical PCD-CT (NAEOTOM Alpha) in UHR mode and a conventional EID-CT (SOMATOM Force) with matched tube potential and radiation dose levels to the PCD-CT. PCD-CT images were reconstructed with a sharp kernel (Qr68) and a quantum iterative algorithm (QIR-3). Two sets of EID-CT images were reconstructed: routine clinical kernel (Qr36, ADMIRE-3) and a sharper kernel (Qr54) with similar noise to PCD-CT images. With institutional review board approval, in vivo exams performed with the PCD-CT in UHR mode were compared against patients' clinical EID-CT exams. The visibility of calcifications on PCD-CT and EID-CT images was assessed and compared qualitatively. RESULTS: PCD-CT images visualized all calcified fragments, while EID-CT failed to detect those below 0.6 mm using a routine protocol. EID-CT with Qr54 improved visibility but distorted boundaries. Calcifications were less visible on EID-CT than PCD-CT as phantom sizes increased. 0.6- and 0.7-mm calcified fragments were barely visible on 35- and 40-cm phantom EID-CT images. Patient cases showed small calcifications missed on EID-CT but detected on PCD-CT. CONCLUSION: At matched radiation dose, PCD-CT in UHR mode provided higher spatial resolution and improved the detectability of small calcified fragments for different phantom/patient sizes in comparison to EID-CT.","journal":"Medical Physics","year":2023,"id":371570,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":6,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9698,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":782423,"name":"Liqiang Ren","orcid":"0000-0002-4095-7486","position":1,"is_corresponding":false},{"id":253787,"name":"Shanshan Tang","orcid":"0000-0002-1115-6479","position":2,"is_corresponding":false},{"id":511067,"name":"Jeffrey F. Marsh","orcid":null,"position":3,"is_corresponding":false},{"id":254230,"name":"Scott S. Hsieh","orcid":"0000-0003-3111-7001","position":4,"is_corresponding":false},{"id":237065,"name":"Cynthia H. McCollough","orcid":"0000-0002-5346-332X","position":5,"is_corresponding":false},{"id":237063,"name":"Shuai Leng","orcid":"0000-0002-6453-9481","position":6,"is_corresponding":false},{"id":577751,"name":"Shaojie Chang","orcid":"0000-0003-0550-9650","position":0,"is_corresponding":true}],"reference_count":27,"raw_metadata":null,"created_at":"2026-07-19T01:15:49.453761Z","pmid":"37650788","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}