Single session photon counting CT protocol for simultaneous screening of coronary and carotid artery disease and lung pathology

Abstract Background Cardiovascular and pulmonary diseases remain leading causes of death, yet population-wide screening is limited by the cumulative burden of three separate computed-tomography (CT) examinations. Photon-counting CT (PCCT) permits spectral, ultra-high-resolution imaging at reduced dose, offering an opportunity to consolidate studies. Purpose To develop and evaluate a single-session PCCT protocol that simultaneously assesses coronary and carotid arteries, thoracic structures, lung parenchyma and myocardial tissue within one breath-hold. Methods The protocol combines four sequential acquisitions: (i) non-contrast coronary artery calcium scoring, (ii) 0.2-mm ultra-high-resolution coronary CT angiography (70 kVp, retrospective ECG-gating), (iii) a