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The aim of this study was to assess the benefits of UHR-PCD-CT pulmonary angiography (CTPA) over dual-energy energy-integrating-detector (EID) CTPA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      Comparing UHR-PCD-CTPA (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200976 at image quality index (IQ) 50,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200976 at IQ25) and dual-energy EID-CTPA (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200975) acquired between April and October 2024, a total of 227 examinations were analyzed in this retrospective single-center study after excluding 56 ineligible studies. Hounsfield unit measurements and subjective image quality ratings of three radiologists (e.g., peripheral pulmonary artery visibility and diagnostic confidence) were investigated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Peripheral pulmonary artery visibility, overall image quality, and self-reported diagnostic confidence were higher in UHR-PCD-CTPA than in EID-CTPA (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01), with no relevant differences between IQ25 and IQ50 scans (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05). Diagnostic confidence was stronger in UHR-PCD-CTPA vs. EID-CTPA (the two highest confidence scores reported by readers after viewing CTPAs and iodine-maps in 92.1\u2013100% of IQ50, 94.6\u2013100% of IQ25 and 66.6\u201373.3% of EID cases). Median attenuation in the pulmonary trunk was higher in UHR-PCD-CTPA (IQ25: 623.3 HU, IQ50: 567.8 HU) compared with EID-CTPA (397.2 HU, all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). CT dose index was highest for IQ50 UHR-PCD-CTPA (6.7\u2009\u00b1\u20092.4\u2009mGy), compared to EID-CTPA (4.7\u2009\u00b1\u20092.7\u2009mGy) and IQ25 UHR-PCD-CTPA (3.0\u2009\u00b1\u20091.0\u2009mGy; all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Image quality of CTPA benefits greatly from employing the UHR-mode in PCD-CT. Compared to EID-CTPA, even UHR-PCD-CTPA scans with a markedly lower radiation dose facilitate superior intraluminal attenuation, peripheral pulmonary artery visibility, and diagnostic confidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Question<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>With the introduction of a UHR scan option for PCD-CT of the pulmonary vasculature, the question arises whether patients benefit from this recent technological advancement.<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Findings<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>UHR-PCD-CTPA offers improved image quality, increased pulmonary artery visibility, and higher diagnostic confidence, even with significant dose reduction compared to conventional EID-CTPA.<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Clinical relevance<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>The advantages in subjective and objective image quality described for UHR-PCD-CTPA suggest potential for superior diagnostic performance in the work-up of pulmonary embolism.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00330-026-12588-3","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T16:35:57Z","timestamp":1777912557000},"page":"7174-7185","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Increasing pulmonary artery visibility and diagnostic confidence with ultra-high resolution photon-counting detector CT pulmonary angiography"],"prefix":"10.1007","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2811-9316","authenticated-orcid":false,"given":"Pauline","family":"Pannenbecker","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"R\u00fcth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Peter","family":"Grunz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alena","family":"Kollmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Gruschwitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julius Frederik","family":"Heidenreich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas Steven","family":"Kunz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thorsten Alexander","family":"Bley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henner","family":"Huflage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"12588_CR1","doi-asserted-by":"publisher","first-page":"1037","DOI":"10.1056\/nejmra072753","volume":"358","author":"VF Tapson","year":"2008","unstructured":"Tapson VF (2008) Acute pulmonary embolism. 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T.A.B. was financially supported by the German Research Foundation. J.P.G., A.S.K., and T.A.B. receive speaker honoraria from Siemens Healthineers. The other authors declare no further relationship with any companies whose products or services may be related to the subject matter of the article.","order":2,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"One of the authors (Jan-Peter Grunz) has significant statistical expertise. Of note, no complex statistical methods were necessary for this paper.","order":3,"name":"Ethics","label":"Statistics and biometry","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"Written informed consent was waived by the institutional review board of the University of W\u00fcrzburg, Germany (IRB number 20241031 01).","order":4,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"Ethical approval was obtained from the institutional review board of the University of W\u00fcrzburg, Germany (IRB number 20241031 01).","order":5,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"No study subjects or cohorts have been previously reported.","order":6,"name":"Ethics","label":"Study subjects or cohorts overlap","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"order":7,"name":"Ethics","label":"Methodology","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}}]}}