Can nontriggered thoracic CT be used for coronary artery calcium scoring? A phantom studyXie, X., Greuter, M. J. W., Groen, J. M., de Bock, G. H., Oudkerk, M., de Jong, P. A. & Vliegenthart, R., Aug-2013, In : Medical Physics. 40, 8, 10 p., 081915.
Research output: Contribution to journal › Article › Academic › peer-review
Purpose: Coronary artery calcium score, traditionally based on electrocardiography (ECG)-triggered computed tomography (CT), predicts cardiovascular risk. However, nontriggered CT is extensively utilized. The study-purpose is to evaluate the in vitro agreement in coronary calcium score between nontriggered thoracic CT and ECG-triggered cardiac CT.
Methods: Three artificial coronary arteries containing calcifications of different densities (high, medium, and low), and sizes (large, medium, and small), were studied in a moving cardiac phantom. Two 64-detector CT systems were used. The phantom moved at 0-90 mm/s in nontriggered low-dose CT as index test, and at 0-30 mm/s in ECG-triggered CT as reference. Differences in calcium scores between nontriggered and ECG-triggered CT were analyzed by t-test and 95% confidence interval. The sensitivity to detect calcification was calculated as the percentage of positive calcium scores.
Results: Overall, calcium scores in nontriggered CT were not significantly different to those in ECG-triggered CT (p > 0.05). Calcium scores in nontriggered CT were within the 95% confidence interval of calcium scores in ECG-triggered CT, except predominantly at higher velocities (>= 50 mm/s) for the high-density and large-size calcifications. The sensitivity for a nonzero calcium score was 100% for large calcifications, but 46% +/- 11% for small calcifications in nontriggered CT.
Conclusions: When performing multiple measurements, good agreement in positive calcium scores is found between nontriggered thoracic and ECG-triggered cardiac CT. Agreement decreases with increasing coronary velocity. From this phantom study, it can be concluded that a high calcium score can be detected by nontriggered CT, and thus, that nontriggered CT likely can identify individuals at high risk of cardiovascular disease. On the other hand, a zero calcium score in nontriggered CT does not reliably exclude coronary calcification. (C) 2013 American Association of Physicists in Medicine.
|Number of pages||10|
|Publication status||Published - Aug-2013|
- Coronary artery calcium, calcium score, imaging phantoms, x-ray computed tomography, nontriggered cardiac imaging technique, ELECTRON-BEAM CT, MULTIDETECTOR COMPUTED-TOMOGRAPHY, CONTAMINATED CALCIFIED PLAQUES, ALL-CAUSE MORTALITY, LUNG-CANCER, HEART-RATE, IN-VIVO, CALCIFICATION DENSITY, TEMPORAL RESOLUTION, PROGNOSTIC VALUE