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

• Age 18 years or older.
• Patients with carotid atherosclerotic plaque or carotid artery stenosis.
• Patients scheduled to undergo carotid artery stenting.
• Patients undergoing preprocedural carotid CTA examination.
• Ability to provide written informed consent.

Exclusion criteria

• Known allergy to iodinated contrast material.
• Severe renal insufficiency or other contraindications to contrast-enhanced CT.
• Pregnancy or suspected pregnancy.
• Severe motion or other artifacts resulting in nondiagnostic image quality.
• Incomplete clinical or imaging data.