Detection of Coronary Calcium During Standard Chest Computed Tomography Correlates With Multi-Detector Computed Tomography Coronary Artery Calcium Score

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.

PMID: 21833776

Posted in Computed Tomography and tagged , , , , .

One Comment

  1. The main idea is simple: Get as much bang for your buck as possible. Many patients undergo CT exams of the chest for various reasons and there will be information on those images that should help risk-stratify those patients… without the need for additional cost and radiation.

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