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Clinically referred patients with severe aortic valve stenosis underwent both, retrospective ECG-gated cardiac UHR-CTA (collimation: 120\u2009\u00d7\u20090.2\u00a0mm) and prospective ECG-triggered aortoiliac HPS-CTA (collimation: 144\u2009\u00d7\u20090.4\u00a0mm, full spectral capabilities) for TAVR planning from August 2022 to March 2023. Radiation dose was extracted from the CT reports, and the effective dose was calculated. Two radiologists analyzed UHR-CTA and HPS-CTA datasets, assessing the image quality of the aortic annulus, with regard to the lumen visibility and margin delineation using a 4-point visual-grading scale (ranges: 4\u2009=\u2009\u201dexcellent\u201d to 1\u2009=\u2009\u201dpoor\u201d). Aortic annulus area (AAA) measurements were taken for valve prosthesis sizing, with retrospective UHR-CTA serving as reference standard. A total of 64 patients were included (mean age, 81\u00a0years\u2009\u00b1\u20097 SD; 28 women) in this retrospective study. HPS-CTA showed a lower radiation dose, 4.1\u00a0mSv vs. 12.6\u00a0mSv (p\u2009&lt;\u20090.001). UHR-CTA demonstrated higher image quality to HPS-CTA (median score, 4 [IQR, 3\u20134] vs. 3 [IQR, 2\u20133]; p\u2009&lt;\u20090.001). Quantitative assessments of AAA from both CTA datasets were strongly positively correlated (mean 477.4\u2009\u00b1\u200991.1 mm<jats:sup>2<\/jats:sup> on UHR-CTA and mean 476.5\u2009\u00b1\u200990.4 mm<jats:sup>2<\/jats:sup> on HPS-CTA, Pearson r<jats:sup>2<\/jats:sup>\u2009=\u20090.857, p\u2009&lt;\u20090.001) with a mean error of 22.3\u2009\u00b1\u200924.6 mm<jats:sup>2<\/jats:sup> and resulted in identical valve prosthesis sizing in the majority of patients (91%). Patients with lower image quality on HPS-CTA (score value 1 or 2, n\u2009=\u200928) were more likely to receive different sizing recommendations (82%). Both UHR-CTA and HPS-CTA acquisitions using photon-counting CT technology provided reliable aortic annular assessments for TAVR planning. While UHR-CTA offers superior image quality, HPS-CTA is associated with lower radiation exposure. However, severely impaired image quality on HPS-CTA may impact on prosthesis sizing, suggesting that immediate post-scan image evaluations may require complementary UHR-CTA scanning.<\/jats:p>","DOI":"10.1007\/s10554-024-03050-w","type":"journal-article","created":{"date-parts":[[2024,2,15]],"date-time":"2024-02-15T18:02:16Z","timestamp":1708020136000},"page":"811-820","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Photon-counting CT-angiography in pre-TAVR aortic annulus assessment: effects of retrospective vs. prospective ECG-synchronization on prosthesis valve selection"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9826-2372","authenticated-orcid":false,"given":"Muhammad Taha","family":"Hagar","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theresa","family":"Kluemper","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel","family":"Hein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Constantin","family":"von Zur Muhlen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Faby","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Capilli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Schuppert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramona","family":"Schmitt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Ruile","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dirk","family":"Westermann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher L.","family":"Schlett","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabian","family":"Bamberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"Krauss","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Soschynski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,2,15]]},"reference":[{"key":"3050_CR1","doi-asserted-by":"publisher","first-page":"744","DOI":"10.1056\/NEJMra1313875","volume":"371","author":"CM Otto","year":"2014","unstructured":"Otto CM, Prendergast B (2014) Aortic-valve stenosis\u2014from patients at risk to severe valve obstruction. 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