Photon-counting CT characterization of carotid perivascular adipose tissue: a layer-by-layer quantitative analysis. A preliminary analysis in an asymptomatic population

Question Can photon-counting CT enable a reliable, layer-by-layer quantitative characterization of carotid perivascular adipose tissue in asymptomatic patients beyond luminal stenosis assessment? Findings Photon-counting CT demonstrated a progressive decrease in PVAT attenuation with increasing distance from the carotid wall and marked inter-individual variability across concentric layers. Clinical relevance Layer-specific PVAT profiling with photon-counting CT may provide a noninvasive imaging marker of local vascular inflammation, supporting improved carotid risk stratification beyond stenosis severity, even in asymptomatic individuals.