Photon-Counting CT Versus Conventional CT for Carotid Plaque Assessment in Patients With Carotid Artery Stenosis

This prospective observational study aims to compare photon-counting detector computed tomography angiography (PCD-CTA) with conventional energy-integrating detector computed tomography angiography (EID-CTA) for the assessment of carotid atherosclerotic plaques in patients with carotid artery stenosis.

The study will evaluate differences between the two CT techniques in the visualization and quantitative characterization of carotid plaques, including plaque morphology, plaque burden, plaque components, calcification-related artifacts, and degree of carotid artery stenosis. Objective and subjective image quality will also be compared.

The study is intended to determine whether the improved spatial resolution and spectral imaging capabilities of photon-counting CT provide advantages over conventional CT for the characterization of carotid atherosclerotic disease.

Inclusion criteria

• Presence or clinical suspicion of carotid atherosclerotic stenosis requiring carotid CT angiography.

Ability to provide written informed consent. Adequate image quality for carotid plaque analysis.

Exclusion criteria

• Known contraindication to iodinated contrast material. Severe renal dysfunction precluding contrast-enhanced CT according to institutional clinical criteria.

Pregnancy. Severe motion or other imaging artifacts resulting in nondiagnostic image quality.