Abstract
It was only fitting that when computed tomography (CT) was celebrating its 50th birthday since its maiden scan in 1971, it was also entering into a new generation in 2021 with the Food and Drug Administration's approval of the first photon-counting detector (PCD)-CT. As non-invasive cardiac imaging is evolving into an ever more important medical field, the introduction of this new technology promises a slew of improvements over energy-integrating detector (EID)-CTs, most importantly improved spatial resolution in the form of ultrahigh-resolution (UHR) imaging, reduced radiation exposure, and routinely acquired spectral information. Spatial resolution has historically been a key hurdle for cardiac CT, especially for coronary imaging where structures in the realm of 2 mm need to be assessed. Initial reports on the use of PCD-CT in cardiac imaging so far have been promising, but many questions ranging from standardized scan protocols to evidence-based recommendations remain. The aim of this review is to discuss the currently available literature regarding the use of UHR PCD-CT for cardiac imaging and explore if it has led to changes in guidelines or patient workflows.