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This study aimed to evaluate quantitative image quality and reader confidence of photon-counting detector computed tomography (PCD-CT)-derived iodine maps for ischemic-type LIE after coronary computed tomography angiography (CTA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>This is a retrospective single-center study including patients referred for work-up of coronary artery disease. LIE was acquired 5\u2009min after contrast injection for coronary CTA (1.5\u2009mL\/kg bodyweight, 350\u2009mg\/mL iodine concentration). Iodine maps were reconstructed (Qr32, 4-mm slices). Contrast-to-noise ratios (CNR) were measured, including scar\u2013myocardium CNR in patients with LIE. Eight readers rated image-quality-based confidence for assessing ischemic-type LIE at \u2264\u200925%, \u2264\u200950%, and &gt;\u200950% transmural extent. Inter-reader agreement was assessed using ICC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty-nine patients (13 women, age 73\u2009\u00b1\u20099 years, BMI 26.7\u2009\u00b1\u20096.6\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) were analyzed; LIE was present in 19\/29 patients. Mean scar\u2013myocardium contrast was 26.5\u2009\u00b1\u20099.8 HU. Median confidence increased with transmural extent: moderate for &lt;\u200925% myocardium thickness (median 3, IQR 3-4), good for \u2264\u200950% (median 2, IQR 1\u20133) and high for &gt;\u200950% (median 1, IQR 1\u20132, all\n                      <jats:italic>p\u2009<\/jats:italic>\n                      &lt;\u20090.001). Inter-reader agreement was good across transmurality categories (ICC\u2009&gt;\u20090.795,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PCD-CT iodine maps acquired 5\u2009min after coronary CTA provided measurable scar conspicuity and high reader confidence for transmural LIE exceeding 50% wall thickness in this small, selected feasibility cohort. Diagnostic accuracy and clinical impact require prospective validation against LGE-MRI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>\n                            <jats:bold>Question:<\/jats:bold>\n                            Delayed PCD-CT iodine maps acquired 5 min after coronary CTA provided interpretable late iodine enhancement images in selected patients.\n                          <\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>\n                            <jats:bold>Findings:<\/jats:bold>\n                            In 29 patients, scar\u2013myocardium CNR was 16.2 \u00b1 7.3; reader confidence was high for enhancement involving 50% of myocardial wall thickness and lower for \u2264 25% involvement.\n                          <\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>\n                            <jats:bold>Relevance statement:<\/jats:bold>\n                            These feasibility data support prospective validation of delayed iodine maps as a targeted adjunct when myocardial scar information is clinically relevant during cardiac CT work-up.\n                          <\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s41747-026-00774-3","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T14:02:49Z","timestamp":1786370569000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Photon-counting CT iodine maps for late iodine enhancement: a retrospective feasibility study of image quality and reader confidence"],"prefix":"10.1186","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6273-9172","authenticated-orcid":false,"given":"Viktor","family":"Hartung","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Gruschwitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia Karin","family":"Serfling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaykumar","family":"Padodara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Dayoub","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramin","family":"Dazeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linus","family":"Desing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alena","family":"Kollmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils","family":"Petri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Peter","family":"Grunz","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":[[2026,8,10]]},"reference":[{"key":"774_CR1","doi-asserted-by":"publisher","first-page":"2350","DOI":"10.1016\/j.jacc.2023.11.007","volume":"82","author":"GA Mensah","year":"2023","unstructured":"Mensah GA, Fuster V, Murray CJL et al (2023) Global burden of cardiovascular diseases and risks, 1990\u20132022. 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