{
  "abstract": "Background Accurate detection and morphology evaluation of unruptured intracranial aneurysms (UIAs) are essential for patient management. This study aimed to assess the efficacy of ultra-high-resolution (UHR) photon-counting detector-CT angiography (PCD-CTA) in detecting UIAs and characterizing their morphological features.Methods This prospective study recruited consecutive participants suspected of cerebral vascular diseases who underwent PCD-CTA and subsequent digital subtraction angiography (DSA) within 1 month from September 2023 to May 2024. Performance of UIA diagnosis using UHR PCD-CTA images (slice thickness 0.2 mm) and standard resolution (SR, reflecting clinical protocols) reconstructed images were compared with DSA as reference on a per-participant, per-vessel, and per-aneurysm basis. The inter-rater agreement for UIA detection and aneurysm morphology characterization using UHR/SR PCD-CTA was also evaluated.Results Among 95 participants, 50 UIAs were confirmed in 42 participants using DSA. The inter-rater agreement for UIA detection was: kappa 0.95 for UHR and 0.89 for SR (p<0.05). On a per-aneurysm basis, the sensitivity, specificity, and diagnostic accuracy of UHR (98.0%, 96.7%, 97.3%) were all significantly higher than SR (72.0%, 86.7%, 80.0%) (p<0.05). UHR PCD-CTA accurately identified 13 of the 14 aneurysms (93%) missed by SR PCD-CTA, including 3 cases (21%) larger than 3 mm. Furthermore, UHR identified more aneurysm irregularity (18/50, 36%) than SR (5/50, 10%) (p=0.004). UHR also revealed 4 (8.0%) more cases with wall calcification and 3 (6.0%) more cases with intra-aneurysmal hypointensity (possible thrombus) than SR.Conclusions The advantages of UHR PCD-CTA, including enhanced reliability, improved diagnostic accuracy, and more comprehensive information, have the potential to significantly optimize UIA management.",
  "authors": [
    {
      "affiliations": [
        "Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"
      ],
      "name": "Naying He"
    },
    {
      "affiliations": [
        "Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"
      ],
      "name": "Haiying Lyu"
    },
    {
      "affiliations": [
        "Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China",
        "College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China"
      ],
      "name": "Youmin Zhang"
    },
    {
      "affiliations": [
        "Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China",
        "College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China"
      ],
      "name": "Ruixi Li"
    },
    {
      "affiliations": [
        "Siemens Healthineers China, Shanghai, China"
      ],
      "name": "Zhihan Xu"
    },
    {
      "affiliations": [
        "Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"
      ],
      "name": "Ewart Mark Haacke"
    },
    {
      "affiliations": [
        "Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Southeast University, Nanjing, Jiangsu Province, China"
      ],
      "name": "Ying Cui"
    },
    {
      "affiliations": [
        "Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"
      ],
      "name": "Jiqiang Li"
    },
    {
      "affiliations": [
        "Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"
      ],
      "name": "Haipeng Dong"
    },
    {
      "affiliations": [
        "Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"
      ],
      "name": "Wentao Han"
    },
    {
      "affiliations": [
        "Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"
      ],
      "name": "Rui Chang"
    },
    {
      "affiliations": [
        "Department of Neurology, Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China",
        "Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"
      ],
      "name": "Zhen Hu"
    },
    {
      "affiliations": [
        "Department of Radiology, University of Washington School of Medicine, Seattle, Washington, USA"
      ],
      "name": "Chengcheng Zhu"
    },
    {
      "affiliations": [
        "Clinical Research Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China",
        "Center for Biomedical Data Science, Translational Science Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China"
      ],
      "name": "Zhangsheng Yu"
    },
    {
      "affiliations": [
        "Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"
      ],
      "name": "Yong Lu"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"
      ],
      "name": "Hong Jiang"
    },
    {
      "affiliations": [
        "Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"
      ],
      "name": "Fuhua Yan"
    }
  ],
  "title": "Increased diagnostic accuracy and better morphology characterization of unruptured intracranial aneurysm by ultra-high-resolution photon-counting detector CT angiography",
  "uid": "b1073067-6f69-5c06-a291-e5611fff72ff"
}