Uploaded: 2026-02-20T12:30:10.000Z
Duration: PT18.320S
Channel: Dr. Filippo Cademartiri

🫀 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

Dr. Filippo Cademartiri

12,295 views • 6 months ago

🔬 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

Dr. Filippo Cademartiri

11,093 views • 7 months ago

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

Dr. Filippo Cademartiri

63,143 views • 1 year ago