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Article History

Received: 6 August 2025

Revised: 3 November 2025

Accepted: 13 December 2025

First Online: 19 February 2026

Compliance with ethical standards

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: The scientific guarantor of this publication is Akos Varga-Szemes.

: The authors of this manuscript declare relationships with the following companies: Akos Varga-Szemes receives institutional research support and/or personal fees from Bayer, Elucid Bioimaging and Siemens. Tilman Emrich received a speaker fee and travel support from Siemens Medical Solutions USA Inc., and institutional research support from Siemens Healthineers. Jim O’Doherty is an employee of Siemens Medical Solutions USA Inc. M.J.W. is a Junior Deputy Editor of European Radiology and, as such, did not participate in the selection or review processes for this article. The remaining authors declare no conflicts of interest.

: No complex statistical methods were necessary for this paper.

: This phantom study did not involve humans or animals. Therefore, Institutional Review Board approval and informed consent were not required.

: Institutional Review Board approval was not required because this is a phantom study.

: The current study is based on a phantom experiment and does not involve human or animal subjects; therefore, IRB approval and informed consent were not required. There is no overlap with previously published work. However, we would like to note that this study is methodologically based on the phantom study published by van Praagh et al [ ], which established a new protocol for CAC scoring on EID-CT systems. Our work adapts their validated approach exclusively to a PCD-CT system and directly compares CAC score reproducibility between the proposed PCD-CT protocol and previous protocols, including the proposed EID-CT protocol. We would like to confirm that this paper (both Part I and Part II) is original and is not under consideration elsewhere. It has not been published in any form previously.

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