Clinical photon-counting computed tomography in living patients detects intra-plaque haemorrhage and thrombus in carotid plaques

In this study of human carotid endarterectomy plaques (using 1128 regions of interest in a total of 10 plaques), we found that photon counting computed tomography (PCCT) can differentiate between attenuation and the spectral patterns of calcium, intra-plaque haemorrhage, thrombus, fibrosis, necrosis and lipid core.This is the first study to show the potential of PCCT in living rupture-prone plaques and, thus, improve risk stratification for diagnosis, prevention or monitoring of therapeutic interventions.