BACKGROUND: Limitations to the coronary calcium score include its requirement for noncontrast imaging and radiation exposure that approaches current methods for contrast-enhanced CT angiography. OBJECTIVES: We sought to derive and validate a method of measuring the coronary artery calcium score (CACS) from standard contrast-enhanced CT, obviating the need for a second non-contrast calcium scan. METHODS: The volume of intramural calcium of >320 HU in major coronary vessels was measured in 90 contrast-enhanced and traditional non-contrast calcium scan pairs. An empiric conversion factor was derived to convert the small voxel contrast-enhanced calcium volume to an Agatston calcium score. The accuracy of this technique was then prospectively validated in 120 consecutive patients undergoing clinical calcium scans and contrasted-enhanced coronary CT. Eleven patients were excluded from analysis because of the prespecified criteria of excessive noise in the contrast-enhanced CT or total coronary artery occlusion. RESULTS: The Pearson correlation of the contrast scan-derived calcium score with the measured CACS was r2 = 0.99. With standard CACS risk bands, agreement of the contrast-enhanced calcium score estimate with the measured CAC by quadratic weighted κ was 0.96. The 95% limits of agreement (Agatston units) were given by ±(3.2 + 0.14 × CACS + 4.44 mean square root of CACS). Inter-observer and intra-observer reliability with the intraclass correlation was 0.99. CONCLUSION: The calcium score can be accurately measured from contrast-enhanced cardiac CT scans with the use of a Hounsfield unit threshold of 320.
BACKGROUND: Limitations to the coronary calcium score include its requirement for noncontrast imaging and radiation exposure that approaches current methods for contrast-enhanced CT angiography. OBJECTIVES: We sought to derive and validate a method of measuring the coronary artery calcium score (CACS) from standard contrast-enhanced CT, obviating the need for a second non-contrast calcium scan. METHODS: The volume of intramural calcium of >320 HU in major coronary vessels was measured in 90 contrast-enhanced and traditional non-contrast calcium scan pairs. An empiric conversion factor was derived to convert the small voxel contrast-enhanced calcium volume to an Agatston calcium score. The accuracy of this technique was then prospectively validated in 120 consecutive patients undergoing clinical calcium scans and contrasted-enhanced coronary CT. Eleven patients were excluded from analysis because of the prespecified criteria of excessive noise in the contrast-enhanced CT or total coronary artery occlusion. RESULTS: The Pearson correlation of the contrast scan-derived calcium score with the measured CACS was r2 = 0.99. With standard CACS risk bands, agreement of the contrast-enhanced calcium score estimate with the measured CAC by quadratic weighted κ was 0.96. The 95% limits of agreement (Agatston units) were given by ±(3.2 + 0.14 × CACS + 4.44 mean square root of CACS). Inter-observer and intra-observer reliability with the intraclass correlation was 0.99. CONCLUSION: The calcium score can be accurately measured from contrast-enhanced cardiac CT scans with the use of a Hounsfield unit threshold of 320.
Authors: Christopher W Pavitt; Katie Harron; Alistair C Lindsay; Robin Ray; Sayeh Zielke; Daniel Gordon; Michael B Rubens; Simon P Padley; Edward D Nicol Journal: Int J Cardiovasc Imaging Date: 2014-05-06 Impact factor: 2.357
Authors: Kjell Bogaard; Friso M van der Zant; Remco J J Knol; Sjoerd Reinders; Marije M G Krul; Albert C van Rossum; Paul Knaapen; Jan H Cornel Journal: Int J Cardiovasc Imaging Date: 2014-08-14 Impact factor: 2.357
Authors: Kyle Wang; Hayley E Malkin; Nicholas D Patchett; Kevin A Pearlstein; Hillary M Heiling; Sean D McCabe; Allison M Deal; Panayiotis Mavroidis; Mary Oakey; Jeffrey Fenoli; Carrie B Lee; J Larry Klein; Brian C Jensen; Thomas E Stinchcombe; Lawrence B Marks; Ashley A Weiner Journal: Int J Radiat Oncol Biol Phys Date: 2021-08-19 Impact factor: 7.038
Authors: Christopher W Pavitt; Katie Harron; Alistair C Lindsay; Sayeh Zielke; Robin Ray; Daniel Gordon; Michael B Rubens; Simon P Padley; Edward D Nicol Journal: Eur Radiol Date: 2015-08-09 Impact factor: 5.315
Authors: Ullrich Ebersberger; Dov Eilot; Roman Goldenberg; Alon Lev; J Reid Spears; Garrett W Rowe; Nicholas Y Gallagher; William T Halligan; Philipp Blanke; Marcus R Makowski; Aleksander W Krazinski; Justin R Silverman; Fabian Bamberg; Alexander W Leber; Ellen Hoffmann; U Joseph Schoepf Journal: Eur Radiol Date: 2012-09-16 Impact factor: 5.315