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Coronary artery calcium: A technical argument for a new scoring method

Willemink, M. J., van der Werf, N. R., Nieman, K., Greuter, M. J. W., Koweek, L. M. & Fleischmann, D., 2019, In : Journal of Cardiovascular Computed Tomography. 13, 6, p. 347-352 6 p.

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  • Coronary artery calcium: A technical argument for a new scoring method

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DOI

  • Martin J Willemink
  • Niels R van der Werf
  • Koen Nieman
  • Marcel J W Greuter
  • Lynne M Koweek
  • Dominik Fleischmann

Coronary artery calcium (CAC) is a strong predictor for future cardiovascular events. Traditionally CAC has been quantified using the Agatston score, which was developed in the late 1980s for electron beam tomography (EBT). While EBT has been completely replaced by modern multiple-detector row CT technology, the traditional CAC scoring method by Agatston remains in use, although the literature indicates suboptimal reproducibility and subjects being incorrectly classified. The traditional Agatston scoring method counteracts the technical advances of CT technology, and prevents the use of thinner sections, obtained at lower tube voltage and overall decreased radiation exposure that has become available to other CT applications. Moreover, recent studies have shown that not only the total amount of CAC, but also its density and distribution in the coronary arterial tree may be of prognostic value. Acquisition and reconstruction techniques thus need to be adapted for modern CT technology and optimized for CAC quantification. In this review we describe the technical limitations of the Agatston score followed by our suggestions for developing a new and more robust CAC quantification method.

Original languageEnglish
Pages (from-to)347-352
Number of pages6
JournalJournal of Cardiovascular Computed Tomography
Volume13
Issue number6
Early online date19-Oct-2018
Publication statusPublished - 2019

    Keywords

  • Coronary artery calcium, Agatston score, Computed tomography, Radiation dose, MULTIDETECTOR COMPUTED-TOMOGRAPHY, ITERATIVE IMAGE-RECONSTRUCTION, ELECTRON-BEAM TOMOGRAPHY, CALCIFICATION DENSITY, REGIONAL MEASURES, SLICE THICKNESS, DOSE REDUCTION, DUAL SOURCE, IN-VITRO, CT

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