Although conventional computed tomography (CT) angiograms and magnetic resonance angiograms visualize stenotic and aneurysmal lesions of the medium vessels, the assessment of distal arterial tree and vessels < 0.2 mm is limited, particularly in the setting of stenosis and atherosclerosis.1 The enhanced novel technology of photo-counting CT (PCCT) measures incoming photons based on individual energy levels, with remarkable spatial resolution that can revolutionize diagnosis of large- and medium-vessel vasculitis.1