OBJECTIVES: The correlation between formal coronary artery calcium scoring (CACS) determined by multi-detector CT (MDCT) and the presence of coronary calcium on standard non-gated CT chest examinations was evaluated.
METHODS: In 163 consecutive healthy participants, we performed screening same-day standard non-gated, non-enhanced CT chest exams followed by high-resolution, ECG-synchronized MDCT exams for CACS. For the standard CT examinations, a scoring system (Weston score, range 0-12) was developed assigning a score (0-3) for each coronary vessel including the left main trunk.
RESULTS: Overall, 30% and 39% of patients had CAC on standard CT and MDCT exams, respectively (P = 0.13). CAC on standard CT was highly correlated to the Agatston CACS on the MDCT (Spearman correlation coefficient 0.83, P < 0.001). Absence of calcium on the standard CT exam was associated with a very low CACS (mean Agatston 0.5, range 0-19). A Weston score >2 identified a CACS > 100 with an area under the curve of 0.976, sensitivity of 100%, and specificity of 85%. A Weston score >7 identified a CACS > 400 with an area under the curve of 0.991, sensitivity of 100%, specificity of 98%. The intra-observer variability was low as was the inter-observer variability between a cardiac specialized radiologist and a non-specialized reader.
CONCLUSIONS: A visual coronary artery scoring system on standard, non-gated CT correlates well
with traditional methods for CACS. Further, a non-expert cardiac radiologist performed equally well to a cardiac expert. This information suggests that a visual scoring system, at least in a descriptive manner can be utilized for a general statement about coronary artery calcification seen on standard CT imaging to guide clinicians in risk stratification.
Imaging Institute and
Latest posts by Schoenhagen Paul (see all)
- Outcomes in hypertrophic cardiomyopathy patients with and without atrial fibrillation: a survival meta-analysis. - February 21, 2017
- Stenotic Flow Reserve Derived from Quantitative Coronary Angiography has Modest but Incremental Value in Predicting Functionally Significant Coronary Stenosis as Evaluated by Fractional Flow Reserve - February 9, 2017
- Gadolinium Retention in the Body and Brain: Is It Time for an International Joint Research Effort? - January 13, 2017