Coronary slow flow is not diagnostic of microvascular dysfunction... in patients with angina and unobstructed coronary arteries. Coronary physiology interrogation has debunked one of the fallacies of the last decades.show more

PHOTON COUNTING CT AND A NEW CONCEPT OF NORMAL... CORONARY ARTERIES For more than 2 decades we have been performing Cardiac CT with constant improvements in all parameters (spatial, temporal and contrast resolution). The improvements were progressive in certain fields and steep in other (e.g.: the introduction of Dual Source CT that completely changed the range of temporal resolution achievable basically overnight and still is the most important source of flexibility in Cardiac CT scanning after almost 20 years). Spatial resolution instead was improved in a slow and progressive way until the test EID CT generations that achieved a spatial resolution of 250 microns. This allowed us to assess a coronary artery tree and define it as normal when no apprentice changes were visibile up to that value. But we know that the normal thickness of coronary artery walls is quite below that threshold. It is more in the range of 80-200 microns. Therefore, the very early changes in coronary artery wall thickness could not be picked up by EID CT technology. With the introduction of PCCT we can constantly achieve 100 microns spatial resolution which means that we work extol in range in which coronary artery disease starts. It also means that we don't see any thickening of the the coronary artery walls we have a much higher specificity and reliability. This concept is a transformative one because it allows us to shift earlier and earlier the beginning of atherosclerosis in our patients and think even more precisely in terms of cardiovascular prevention and monitoring. Movie: example of normal coronary artery tree with PCCT. A new era is coming into practice and it is the age of Photon Counting CT which pushes this boundaries further away. PCCT is a NEW Imaging Modality. PCCT is changing the game, the field, the language, the priorities and in the end it will change the entire infrastructure of diagnostic medicine. PS: note that PCCT images have to be reduced in resolution when uploaded in social media. #CardiacImaging #MedicalInnovation #StentAssessment #Radiology #PCCT #photoncounting #QuantumHD #CT #computedtomography #yesCCT #coronaryarterydisease #ischemia #naeotomalpha #Peak #Pro #Prime #speed #cardiac #highresolution #siemenshealthinners #CardiacCT #PhotonCountingCT #MedicalImaging #HeartHealth #CardiovascularInnovation #Radiology #AIInMedicineshow more

Did #aorticDissection with valve sparing #DavidV in young patient... with type A and anomalous right coronary artery from the left coronary sinus. Rei planted the RCA with #Cabrol Vein Graft to Ascending Aorta. Thanks to Corey Herman and the rest of the team for the great help!show more

🫀 Seeing Truly Normal Coronary Arteries Dual Source PCCT... + High Iodine = Confidence of Exclusion In coronary CTA, detecting plaque matters. But confidently proving absence of plaque is even more powerful. A truly normal coronary artery should not look “probably normal.” It should look sharp, smooth, motion-free, and perfectly opacified. That level of certainty comes from the combination of: - Photon-Counting CT (PCCT) - High spatial/temporal/contrast resolution - High iodine concentration contrast (400 mg I/mL) 🧠 Why this combination matters Subtle abnormalities can be masked by: - Motion blur - Noise - Partial volume effects - Insufficient intraluminal enhancement Sometimes what we call “normal” is simply underpowered imaging. ⚡ What changes with PCCT + 400 mg I/mL Ultra-high spatial resolution - Clear intima–lumen interface - Distal vessels sharply defined High temporal resolution - Minimal motion artifacts - True coronary borders, even at higher HR High iodine concentration (400 mg I/mL) - Stronger intraluminal signal - Higher contrast-to-noise ratio - Uniform, stable lumen opacification - Subtle wall irregularities no longer hide in low signal Spectral capability - Cleaner iodine–tissue separation - Greater confidence in excluding non-calcified plaque When arteries are truly normal, they appear: ✔️ Smooth ✔️ Thin-walled ✔️ Motion-free ✔️ Intensely and uniformly opacified Not “likely fine.” But objectively pristine. In coronary CTA, technology is not only about finding disease. It’s about confidently saying: There is none. From uncertainty to reassurance. From suspicion to precision. That’s the strength of PCCT with high-iodine coronary imaging. ⚡🫀 #PhotonCountingCT #PCCT #CoronaryCTA #HighIodine #400mgIodine #HighTemporalResolution #UltraHighResolution #CardiacCT #PreventiveCardiology #yesCCTshow more

Here's an amazing 3D Reconstruction from a Coronary CTA... of a 25-year-old woman who suddenly collapsed to the ground in cardiac arrest while running What's the diagnosis?show more

How to handle this LAD, D1& D2. One important... thing to mention there is a small coronary cameral fistula from the distal lad to LV visible at the end of the cine. This can create confusion as wire perforation after intervention.show more

On CCU teaching rounds today I planned to review... the vascular biology of acute coronary syndromes … then I heard that surgical Giants Eddie Cornwell, Terrence Fullum, & Andre Campbell were in the conference rm. I said “Team, follow me. This is history.” HU Department of Surgeryshow more

Spontaneous coronary artery dissection in the setting of phytoestrogen... use: a cautionary case #EHJCaseReports Philipp Sommer Tee Joo YEO Aaysha Cader Boldizsar Kovacs Sukriti Banthiya A.Nazmi Calik Obayda Azizy Sara Moscatelli EHJCaseReports Editor-in-Chief #CardioX #EPeepsshow more

1/ Time to share an amazing case that I... had the pleasure to be a part of with #IRAD #Cardiotwitter teamwork with Justin Stenz, MD Patient with recurrent heart failure and found to have bypass graft to the coronary sinus. We decided to coil to reduce right heart filling.show more

Last guest in Asia this evening. Holy the unobstructed... views of this park with no other people are insane. Time and time again Animal Kingdom is most certainly one of a kind.show more

"Christians and Muslims and Jews all worship the same... God.” - James Talarico. This man is not a Christian, as he is falling prey to one of the oldest religious fallacies in the book.show more

🔬 Why Perfect Visualization of Stents and Calcified Plaques... Requires the Highest Spatial, Temporal and Contrast Resolution: The Case for Ultra-High-Resolution with Photon Counting CT Image: a close look at a RCA stent with very mild intimal hyperplasia. Seeing is everything in coronary imaging. Yet when it comes to stents and heavily calcified plaques, even the best conventional CT systems hit their physical limits — blooming, partial volume effects, and metal artifacts blur what truly matters. That’s where Ultra-High-Resolution Photon Counting CT (PCCT) changes the game. 🧠 Why it matters: Conventional CT often overestimates stenosis in calcified vessels and hides in-stent lumen due to blooming and noise. This leads to diagnostic uncertainty, unnecessary invasive testing, and poor evaluation of stent patency or neo-atherosclerosis. ⚡ What PCCT adds: Ultra-high spatial resolution (0.1 mm voxels) sharply delineates stent struts, plaque borders, and residual lumen. True spectral resolution minimizes blooming and metal artifacts, enhancing visualization even in highly calcified segments. Improved contrast-to-noise enables clear lumen assessment at lower doses. Quantitative, energy-resolved data provide material differentiation between calcium, metal, and contrast — something previously unthinkable in CT. In short, accurate visualization of stents and calcified plaques demands Photon Counting CT — not just for sharper images, but for better diagnostic confidence and patient management. The era of artifact-free coronary imaging has begun — and it’s photon-counting powered. ⚡❤️ #PCCT #CardiacImaging #CoronaryCT #StentImaging #CalciumScore #PhotonCountingCT #PrecisionImaging #CardiovascularImaging #RadiologyInnovation #yesCCTshow more

Odesa was also under attack overnight: the “7th Kilometer”... market was hit The market is considered one of the largest wholesale and retail clothing markets in Europe and has been one of the symbols of Odesa’s commercial life for decades ❤️‍🩹show more

YOUR NEW CAR ISN'T NEW! This is one of... the biggest fallacies when you import a vehicle. This car has been on the road for thousands of KMs....and, NO, the Japanese govt doesn't inspect such. This is carbon in the intake of a 2019 Mazda CX5 diesel, it's a normal thing...cont'dshow more

Babies and women killed execution style? Look up the... Sabra and Shatila massacre in the 1980s. As Palestinians, we’ve been dealing with the worst of what we’re accused of for decades. But they keep repeating debunked reports and ignoring an actual genocide.show more

SPACE VACUUM DEBUNKED IN 20 SECONDS Gas pressure and... the 2nd Law of Thermodynamics prove that the Earth is contained and not in a vacuumshow more

Since this morning’s reports of a raid of Kamal... Adwan Hospital in northern #Gaza, we have lost touch with the personnel there. This development is deeply disturbing given the number of patients being served and people sheltering there. Prior to this, World Health Organization (WHO) and partners managed to reach Kamal Adwan Hospital late last night, amid hostilities in the vicinity, and transferred 23 patients and 26 caregivers to Al-Shifa Hospital. The team also delivered 180 units of blood, trauma and surgical supplies and medicines for over 5000 patients. Kamal Adwan Hospital has been overflowing with close to 200 patients - a constant stream of horrific trauma cases. It is also full of hundreds of people seeking shelter. Accessing hospitals across #Gaza is getting unbelievably harder and exposes our staff to unnecessary danger. The mission returned at 3.30 am. We call for an immediate ceasefire; and protection of hospitals, patients, health professionals and humanitarians. Everyone in Gaza needs peace.show more

ZZ Top performing this summer. Billy Gibbons is the... only surviving member of the classic lineup. The band has been one of the most influential in Southern rock for decades, but sadly, Billy is the only one still with us. Video recorded by us, by Rock History.show more