To review the technical basis, imaging biomarkers, and clinical significance of spectral computed tomography (CT) for coronary plaque characterization.
Key Findings:
Spectral CT improves plaque composition characterization through energy-dependent attenuation patterns.
Higher spatial resolution and reduced blooming enhance structural fidelity in calcified lesions.
Current evidence indicates spectral CT's value in accurate assessment of calcified lesions.
Interpretation:
Limitations:
Insufficient evidence for robust incremental value in long-term prognostic prediction.
Barriers include cross-platform inconsistency, lack of quantitative standardization, limited scanner availability, and post-processing burden.
Conclusion:
Broader clinical translation of spectral CT will depend on hardware refinement, quantitative standardization, workflow integration, and prospective validation.
