Antoine Hutt1, Alain Duhamel2, Valérie Deken2, Jean-Baptiste Faivre1, Francesco Molinari3, Jacques Remy1, Martine Remy-Jardin4. 1. Department of Thoracic Imaging, Hospital Calmette (EA 2694), CHRU et Université de Lille, Lille, France. 2. Department of Biostatistics (EA 2694), CHRU et Université de Lille, Lille, France. 3. Department of Radiology, Centre Hospitalier Général de Tourcoing, Tourcoing, France. 4. Department of Thoracic Imaging, Hospital Calmette (EA 2694), CHRU et Université de Lille, Lille, France. martine.remy@chru-lille.fr.
Abstract
PURPOSE: To investigate the reliability of ungated, high-pitch dual-source CT for coronary artery calcium (CAC) screening. MATERIALS AND METHODS: One hundred and eighty-five smokers underwent a dual-source CT examination with acquisition of two sets of images during the same session: (a) ungated, high-pitch and high-temporal resolution acquisition over the entire thorax (i.e., chest CT); (b) prospectively ECG-triggered acquisition over the cardiac cavities (i.e., cardiac CT). RESULTS: Sensitivity and specificity of chest CT for detecting positive CAC scores were 96.4 % and 100 %, respectively. There was excellent inter-technique agreement for determining the quantitative CAC score (ICC = 0.986). The mean difference between the two techniques was 11.27, representing 1.81 % of the average of the two techniques. The inter-technique agreement for categorizing patients into the four ranks of severity was excellent (weighted kappa = 0.95; 95 % CI 0.93-0.98). The inter-technique differences for quantitative CAC scores did not correlate with BMI (r = 0.05, p = 0.575) or heart rate (r = -0.06, p = 0.95); 87.2 % of them were explained by differences at the level of the right coronary artery (RCA: 0.8718; LAD: 0.1008; LCx: 0.0139; LM: 0.0136). CONCLUSION: Ungated, high-pitch dual-source CT is a reliable imaging mode for CAC screening in the conditions of routine chest CT examinations. KEY POINTS: • CAC is an independent risk factor for major cardiac events. • ECG-gated techniques are the reference standard for calcium scoring. • Great interest is directed toward calcium scoring on non-gated chest CT examinations. • Reliable calcium scoring can be obtained with dual-source CT in a high-pitch mode.
PURPOSE: To investigate the reliability of ungated, high-pitch dual-source CT for coronary artery calcium (CAC) screening. MATERIALS AND METHODS: One hundred and eighty-five smokers underwent a dual-source CT examination with acquisition of two sets of images during the same session: (a) ungated, high-pitch and high-temporal resolution acquisition over the entire thorax (i.e., chest CT); (b) prospectively ECG-triggered acquisition over the cardiac cavities (i.e., cardiac CT). RESULTS: Sensitivity and specificity of chest CT for detecting positive CAC scores were 96.4 % and 100 %, respectively. There was excellent inter-technique agreement for determining the quantitative CAC score (ICC = 0.986). The mean difference between the two techniques was 11.27, representing 1.81 % of the average of the two techniques. The inter-technique agreement for categorizing patients into the four ranks of severity was excellent (weighted kappa = 0.95; 95 % CI 0.93-0.98). The inter-technique differences for quantitative CAC scores did not correlate with BMI (r = 0.05, p = 0.575) or heart rate (r = -0.06, p = 0.95); 87.2 % of them were explained by differences at the level of the right coronary artery (RCA: 0.8718; LAD: 0.1008; LCx: 0.0139; LM: 0.0136). CONCLUSION: Ungated, high-pitch dual-source CT is a reliable imaging mode for CAC screening in the conditions of routine chest CT examinations. KEY POINTS: • CAC is an independent risk factor for major cardiac events. • ECG-gated techniques are the reference standard for calcium scoring. • Great interest is directed toward calcium scoring on non-gated chest CT examinations. • Reliable calcium scoring can be obtained with dual-source CT in a high-pitch mode.
Entities:
Keywords:
Calcium score; Dual-source CT; High pitch; Ungated-CT
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