{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T06:45:30Z","timestamp":1782801930338,"version":"3.54.5"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"vor","delay-in-days":110,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007368","name":"Fondazione Pisa","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007368","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Preventive imaging for cardiothoracic risk is fragmented across separate pathways. Photon-counting CT (PCCT) may consolidate coronary, aortic\u2013carotid, and pulmonary assessment into a single session while maintaining diagnostic performance and controlling dose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>ACTA is an ongoing, general-practitioner\u2013initiated, risk-enriched screening study (age 45\u201375 years; diabetes \u226510 years, current\/recent smoking, or Framingham hard coronary artery disease risk \u226510%). The protocol integrates non-contrast calcium scoring, ultra-high-resolution coronary CT angiography, a high-pitch thoraco-cervical sweep, and brief late iodine enhancement (LIE). Incidental findings trigger predefined, guideline-concordant referrals. The primary endpoint is the prevalence of obstructive (\u226550%) and\/or extensive (\u22652-vessel) coronary artery disease. This interim analysis includes participants imaged 11 January to 21 June 2025. Of 223 invited, 172 underwent PCCT; all completed without complications. Mean dose-length product was \u223c740 mGy\u00b7cm; the effective dose was 12.6 mSv (IQR 10.5\u201317.1 mSv), and weight-adapted contrast equalled \u223c0.44\u20130.48 gI\/kg. Any coronary atherosclerosis was present in 129\/172 (75%); the primary endpoint was met in 98\/172 (57%). Carotid plaques occurred in 94\/170 (55%); lung-RADS 3\u20134 in 16\/172 (9%); emphysema in 41\/172 (24%). Management actions included invasive coronary angiography in 8\/172 (5%), targeted vascular and pulmonary referrals, initiation\/intensification of prevention therapies, and structured follow-up. Incidental extracardiac findings were common but managed via protocolized pathways.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Single-session PCCT feasibly consolidates comprehensive cardiothoracic assessment with controlled radiation\/iodine exposure and structured downstream care. Preliminary yield suggests actionable information in high-risk, asymptomatic adults; ongoing follow-up and prespecified economic analyses will determine clinical outcomes and cost-effectiveness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjimp\/qyag074","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T12:52:05Z","timestamp":1776430325000},"source":"Crossref","is-referenced-by-count":0,"title":["Single-session photon-counting CT protocol for simultaneous screening of coronary and carotid artery disease and lung pathology"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6051-3698","authenticated-orcid":false,"given":"Carmelo","family":"De Gori","sequence":"first","affiliation":[{"name":"Radiology Department, Fondazione Toscana Gabriele Monasterio , Pisa e Massa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9129-9519","authenticated-orcid":false,"given":"Alberto","family":"Aimo","sequence":"additional","affiliation":[{"name":"Cardiology Department, Fondazione Toscana Gabriele Monasterio , via G. Moruzzi 1, Pisa 56124 ,","place":["Italy"]},{"name":"Interdisciplinary Center for Health Sciences, Scuola Superiore Sant\u2019Anna , Piazza Martiri della Libert\u00e0, 33, Pisa 56127 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luna","family":"Latorre","sequence":"additional","affiliation":[{"name":"University of Pisa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denisa Simona","family":"Zai","sequence":"additional","affiliation":[{"name":"Radiology Department, Fondazione Toscana Gabriele Monasterio , Pisa e Massa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Bruschi","sequence":"additional","affiliation":[{"name":"Radiology Department, Fondazione Toscana Gabriele Monasterio , Pisa e Massa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariaelena","family":"Occhipinti","sequence":"additional","affiliation":[{"name":"Radiology Department, Fondazione Toscana Gabriele Monasterio , Pisa e Massa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matilda","family":"Muca","sequence":"additional","affiliation":[{"name":"Radiology Department, Fondazione Toscana Gabriele Monasterio , Pisa e Massa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Pignatelli","sequence":"additional","affiliation":[{"name":"Radiology Department, Fondazione Toscana Gabriele Monasterio , Pisa e Massa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Emdin","sequence":"additional","affiliation":[{"name":"Cardiology Department, Fondazione Toscana Gabriele Monasterio , via G. Moruzzi 1, Pisa 56124 ,","place":["Italy"]},{"name":"Interdisciplinary Center for Health Sciences, Scuola Superiore Sant\u2019Anna , Piazza Martiri della Libert\u00e0, 33, Pisa 56127 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Clemente","sequence":"additional","affiliation":[{"name":"Radiology Department, Fondazione Toscana Gabriele Monasterio , Pisa e Massa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,4,18]]},"reference":[{"key":"2026063002112410900_qyag074-B1","first-page":"e41","article-title":"2025 heart disease and stroke statistics: a report of US and global data from the American Heart Association","volume":"151","author":"Martin","year":"2025","journal-title":"Circulation"},{"key":"2026063002112410900_qyag074-B2","doi-asserted-by":"crossref","first-page":"1754","DOI":"10.1001\/jama.2014.14681","article-title":"Nonobstructive coronary artery disease and risk of myocardial infarction","volume":"312","author":"Maddox","year":"2014","journal-title":"JAMA"},{"key":"2026063002112410900_qyag074-B3","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1056\/NEJMoa1805971","article-title":"Coronary CT angiography and 5-year risk of myocardial infarction","volume":"379","author":"SCOT-HEART Investigators","year":"2018","journal-title":"N Engl J Med"},{"key":"2026063002112410900_qyag074-B4","doi-asserted-by":"crossref","first-page":"901","DOI":"10.4070\/kcj.2022.0302","article-title":"Reclassification of cardiovascular risk based on the presence of carotid plaque regarding statin eligibility in low to moderate risk patients","volume":"52","author":"Park","year":"2022","journal-title":"Korean Circ J"},{"key":"2026063002112410900_qyag074-B5","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.123.030739","article-title":"Carotid plaque score for stroke and cardiovascular risk prediction in a middle-aged cohort from the general population","volume":"12","author":"Ihle-Hansen","year":"2023","journal-title":"J Am Heart Assoc"},{"key":"2026063002112410900_qyag074-B6","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1016\/j.jacr.2023.09.009","article-title":"ACR lung-RADS v2022: assessment categories and management recommendations","volume":"21","author":"Christensen","year":"2024","journal-title":"J Am Coll Radiol"},{"key":"2026063002112410900_qyag074-B7","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2021.8559","article-title":"Patterns and factors associated with adherence to lung cancer screening in diverse practice settings","volume":"4","author":"Sakoda","year":"2021","journal-title":"JAMA Netw Open"},{"key":"2026063002112410900_qyag074-B8","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.diii.2024.09.002","article-title":"Photon-counting CT systems: a technical review of current clinical possibilities","volume":"106","author":"Greffier","year":"2025","journal-title":"Diagn Interv Imaging"},{"key":"2026063002112410900_qyag074-B9","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1093\/eurjpc\/zwab154","article-title":"2021 ESC guidelines on cardiovascular disease prevention in clinical practice","volume":"29","author":"Visseren","year":"2022","journal-title":"Eur J Prev Cardiol"},{"key":"2026063002112410900_qyag074-B10","doi-asserted-by":"crossref","first-page":"1837","DOI":"10.1161\/01.CIR.97.18.1837","article-title":"Prediction of coronary heart disease using risk factor categories","volume":"97","author":"Wilson","year":"1998","journal-title":"Circulation"},{"key":"2026063002112410900_qyag074-B11","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.jcct.2016.10.002","article-title":"SCCT guidelines for the performance and acquisition of coronary computed tomographic angiography: a report of the society of Cardiovascular Computed Tomography Guidelines Committee: Endorsed by the North American Society for Cardiovascular Imaging (NASCI)","volume":"10","author":"Abbara","year":"2016","journal-title":"J Cardiovasc Comput Tomogr"},{"key":"2026063002112410900_qyag074-B12","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.jcmg.2023.09.005","article-title":"Carotid plaque-RADS: a novel stroke risk classification system","volume":"17","author":"Saba","year":"2024","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026063002112410900_qyag074-B13","doi-asserted-by":"crossref","first-page":"433","DOI":"10.7326\/M22-3027","article-title":"Subclinical coronary atherosclerosis and risk for myocardial infarction in a Danish Cohort : a prospective observational Cohort study","volume":"176","author":"Fuchs","year":"2023","journal-title":"Ann Intern Med"},{"key":"2026063002112410900_qyag074-B14","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1016\/j.jcct.2022.07.002","article-title":"CAD-RADS\u2122 2.0 - 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