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A method for coronary artery calcium scoring using contrast-enhanced computed tomography.
MedLine Citation:
PMID:  22210533     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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 r(2) = 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+4.44CACS). 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:
James M Otton; Jacob T Lønborg; David Boshell; Michael Feneley; Andrew Hayen; Neville Sammel; Ken Sesel; Lourens Bester; Jane McCrohon
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-20
Journal Detail:
Title:  Journal of cardiovascular computed tomography     Volume:  -     ISSN:  1876-861X     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2012-1-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101308347     Medline TA:  J Cardiovasc Comput Tomogr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.
Affiliation:
Cardiology Department, St Vincent's Hospital, Darlinghurst Sydney 2010, Australia; University of New South Wales, Australia.
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