{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T23:00:14Z","timestamp":1785279614051,"version":"3.55.0"},"reference-count":12,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rofo"],"abstract":"Abstract<\/jats:title>\n To evaluate the diagnostic accuracy of photon-counting coronary CT angiography (PCCT-CCTA) for assessing coronary artery stenosis, using invasive coronary angiography (ICA) as the reference standard.<\/jats:p>\n 90 adult patients who underwent PCCT-CCTA followed by consecutive ICA were included in this retrospective single-center study. PCCT-CCTA examinations were performed in standard-resolution or ultra-high resolution. Image quality, coronary stenosis severity, and CAD-RADS 2.0 classifications were assessed by blinded experienced radiologists. ICA findings served as the reference standard. Statistical analyses included Wilcoxon signed-rank testing, Spearman correlation, ROC analysis, and calculation of overestimation, underestimation, and concordance rates.<\/jats:p>\n The overall image quality was excellent (median Likert score 5). PCCT-CCTA demonstrated high sensitivity and negative predictive value for identifying patients requiring invasive therapy at a CAD-RADS score >3, but the specificity was low. PCCT-CCTA significantly differed from ICA in stenosis grading (p = 0.001) and showed a tendency to overestimate stenosis severity, particularly in mild to moderate lesions. The overall overestimation rate was 66.8%, the underestimation rate was 9.3%, and the concordance rate was 23.9%. Ultra-high resolution improved the detection of severe stenoses but did not eliminate overestimation. The CAD-RADS score demonstrated limited discriminatory performance for therapy prediction (AUC 0.581). No significant correlations were found between Agatston score, CAD-RADS 2.0 classification, and image quality.<\/jats:p>\n PCCT-CCTA reliably identifies patients requiring invasive coronary therapy but tends to overestimate stenosis severity compared with ICA. Despite this limitation, PCCT-CCTA represents a valuable noninvasive gatekeeper for invasive coronary angiography.<\/jats:p>","DOI":"10.1055\/a-2901-9309","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T22:37:18Z","timestamp":1785278238000},"source":"Crossref","is-referenced-by-count":0,"title":["The Accuracy of Photon-Counting CT Angiography of the Coronaries Compared to Invasive Coronary Angiography"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8598-1295","authenticated-orcid":false,"given":"Nina Pauline","family":"Haag","sequence":"additional","affiliation":[{"name":"Ruhr University Bochum, Germany","place":["Minden"],"department":["Institute of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital Minden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2063-1269","authenticated-orcid":false,"given":"Maria Sophie","family":"Katz","sequence":"additional","affiliation":[{"name":"Ruhr University Bochum, Germany","place":["Minden"],"department":["Institute of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital Minden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Wiemer","sequence":"additional","affiliation":[{"name":"Ruhr University Bochum, Germany","place":["Minden"],"department":["Department of Cardiology and Critical Care Medicine, Johannes Wesling University Hospital"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Kaese","sequence":"additional","affiliation":[{"name":"Ruhr University Bochum, Germany","place":["Minden"],"department":["Department of Cardiology and Critical Care Medicine, Johannes Wesling University Hospital"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saher","family":"Saeed","sequence":"additional","affiliation":[{"name":"Ruhr University Bochum, Germany","place":["Minden"],"department":["Institute of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital Minden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2908-7560","authenticated-orcid":false,"given":"Jan","family":"Borggrefe","sequence":"additional","affiliation":[{"name":"Ruhr University Bochum, Germany","place":["Minden"],"department":["Institute of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital Minden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Robert","family":"Kr\u00f6ger","sequence":"additional","affiliation":[{"name":"Ruhr University Bochum, Germany","place":["Minden"],"department":["Institute of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital Minden"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e136","DOI":"10.1093\/ehjci\/jeab292","article-title":"Clinical applications of cardiac computed tomography: a consensus paper of the European Association of Cardiovascular Imaging \u2013 part II","volume":"23","author":"G Pontone","year":"2022","journal-title":"European Heart Journal \u2013 Cardiovascular Imaging"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00117-022-01096-2","article-title":"Positionspapier von DRG und BDR zur Computertomografie des Herzens: Klinische Evidenz und Versorgungsqualit\u00e4t beim chronischen Koronarsyndrom","volume":"63","author":"MC Langenbach","year":"2023","journal-title":"Die Radiologie"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e368","DOI":"10.1161\/CIR.0000000000001029","article-title":"2021 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