Evaluation of Coronary Artery Disease Using Photon-counting CT Compared to Invasive Imaging Study on Non-invasive Coronary Plaque Characterization in Acute and Chronic Coronary Syndrome Patients

What this Trial Is About

Researchers are evaluating the accuracy and limitations of photon-counting computed tomography PCCT for assessing coronary plaque in patients with acute or chronic coronary syndrome. The study aims to determine if cardiac ultra-high resolution PCCT, which offers better spatial resolution and soft tissue contrast than conventional CT, can be a reliable, non-invasive alternative to invasive imaging methods like optical coherence tomography OCT and intravascular ultrasound IVUS. This observational study will enroll 100 patients, including subgroups with suspected in-stent restenosis and those one year after percutaneous coronary intervention for chronic total occlusion. Participants will undergo a dedicated cardiac ultra-high resolution PCCT scan within 24 hours for acute coronary syndrome patients or within 72 hours for chronic coronary syndrome patients, scheduled before invasive coronary angiography. Alongside PCCT, invasive OCT will be performed during angiography, and a subgroup of 10 patients will also have IVUS imaging to allow direct comparison of these methods. The study evaluates PCCTs ability to characterize plaque features, measure plaque volume, and support coronary reconstruction. During the study, participants will have PCCT imaging shortly before invasive angiography, followed by OCT and, for some, IVUS. Researchers will assess the diagnostic accuracy of PCCT compared to OCT within 72 hours, focusing on high-risk plaque features and plaque volume. The study involves careful monitoring of imaging results and clinical data to understand how PCCT findings correlate with established invasive imaging techniques. The total participation duration depends on the timing of these procedures but includes assessments completed within a few days of each other.

Coronary Evaluation And Guided Lesion Exploration Using Photon-counting CT and Intracoronary Imaging Techniques