Assessment of isotropic calcium using 0.5-mm reconstructions from 320-row CT data sets identifies more patients with non-zero Agatston score and more subclinical atherosclerosis than standard 3.0-mm coronary artery calcium scan and CT angiography

Aslam, Anum; Khokhar, Usman; Chaudhry, Ammar; Abramowicz, Alexander; Rajper, Naveed; Cortegiano, Michael; Poon, Michael; Vörös, Szilárd

doi:10.1016/j.jcct.2013.12.007

Cited by 20 publications

(27 citation statements)

References 19 publications

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“…We found small calcifications in 14% of patients with zero CAC scores from conventional 3.0-mm reconstructions. The proportion was similar or lower than that in previous reports, and several articles demonstrated that the conventional CAC method misclassified 21%–23% of patients 13, 14, 24) . In addition, Van der Biji et al reported that in thin-slice reconstruction, the Agatston score was overestimated because the peak CT attenuation number in each voxel was counted 14) .…”

Section: Discussionsupporting

confidence: 73%

“…However, in the new-generation, 320-slice CT, 3.0-mm slice images are reconstructed from 0.5-mm slice, whole-heart data, and then 0.5-mm slice reconstruction images are available without additional radiation exposure 13) . The study found that small amounts of coronary calcium could be distinguished more sensitively with thin 0.5-mm slice reconstruction than with standard 3.0-mm reconstruction, resulting in a positive calcium score in 21% of patients who had zero calcium scores in standard reconstruction 14) .…”

Section: Introductionmentioning

confidence: 99%

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Identifying Small Coronary Calcification in Non-Contrast 0.5-mm Slice Reconstruction to Diagnose Coronary Artery Disease in Patients with a Conventional Zero Coronary Artery Calcium Score

Urabe

Yamamoto

Kitagawa

et al. 2016

JAT

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Aims: In a new-generation computed tomography (CT) scanner, coronary artery calcium (CAC) scores were measured using 3.0-mm slice reconstruction images originally acquired with 0.5 mm thickness scans in a single beat. This study investigated the usefulness of thin-slice (0.5 mm) reconstruction for identifying small calcifications in coronary arteries and evaluated the association with coronary plaques and stenosis compared to conventional 3.0-mm reconstruction images.Methods: We evaluated 132 patients with zero CAC scores in conventional 3.0-mm Agatston method using a 320-slice CT. Then, 0.5-mm slice reconstruction was performed to identify small calcifications. The presence of stenosis and coronary plaques was assessed using coronary CT angiography.Results: In total, 22 small calcifications were identified in 18 patients. There were 28 (21%) patients with any (≥ 25%) stenosis (34 lesions). Forty-seven coronary plaques were found in 33 patients (25%), including 7 calcified plaques in 7 patients (5%), 34 noncalcified plaques in 27 patients (20%), and 6 partially calcified plaques in 5 patients (4%). Patients with small calcifications had a significantly higher prevalence of noncalcified or partially calcified plaques (83% vs 14%; p < 0.001) and obstructive stenosis (33% vs 5.2%; p < 0.001) compared to those without small calcifications. The addition of small calcifications to the coronary risk factors when diagnosing stenosis significantly improved the diagnostic value.Conclusion: Small calcifications detected by thin-slice 0.5-mm reconstruction are useful for distinguishing coronary atherosclerotic lesions in patients with zero CAC scores from conventional CT reconstruction.

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Section: Discussionsupporting

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Identifying Small Coronary Calcification in Non-Contrast 0.5-mm Slice Reconstruction to Diagnose Coronary Artery Disease in Patients with a Conventional Zero Coronary Artery Calcium Score

Urabe

Yamamoto

Kitagawa

et al. 2016

JAT

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“…In the Bland-Altman plots, we observed that the higher the degree of calcification, the larger the difference between thick and thin slices reconstruction protocols for both the modified Agatston and volume score. This heterogeneity in calcium quantification for the use of slice thickness protocols has been reported by other authors before [17][18][19][20][21].…”

Section: Discussionsupporting

confidence: 62%

Computed tomography-based calcium scoring in cadaver leg arteries: Influence of dose, reader, and reconstruction algorithm

Jong

Star

Bleys

et al. 2022

European Journal of Radiology

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Computed tomography (CT) might be a good diagnostic test to accurately quantify calcium in vascular beds but there are multiple factors influencing the quantification. The aim of this study was to investigate the influence of different computed tomography protocol settings in the quantification of calcium in the lower extremities using modified Agatston and volume scores. Methods: Fresh-frozen human legs were scanned at different tube current protocols and reconstructed at different slice thickness. Two different iterative reconstruction protocols for conventional CT images were compared. Calcium was manually scored using modified Agatston and volume scores. Outcomes were statistically analyzed using Wilcoxon signed-rank tests and mean absolute and relative differences were plotted in Bland-Altman plots. Results: Of the 20 legs, 16 had CT detectable calcifications. Differences between thick and thin slice reconstruction protocols were 129 Agatston units and 125% for Agatston and 78.4 mm 3 and 57.8% for volume (all p ≤ 0.001). No significant differences were found between low and high tube current protocols. Differences between iDose 4 and IMR reconstruction protocols for modified Agatston were 34.2 Agatston units and 17.7% and the volume score 33.5 mm 3 and 21.2% (all p ≤ 0.001). Conclusions: Slice thickness reconstruction and reconstruction method protocols influenced the modified Agatston and volume scores in leg arteries, but tube current and different observers did not have an effect. This data emphasizes the need for standardized quantification of leg artery calcifications. Possible implications are in the development of a more universal quantification method, independent of the type of scan and vasculature.

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“…It requires only one heartbeat, covers the entire heart, and provides uniform, high isotropic spatial resolution (0.5 mm) 3 . 15 Compared with other modalities, VCI may be useful for detecting small abnormal lesions.…”

Section: Discussionmentioning

confidence: 99%

Vectors through a cross-sectional image (VCI): A visualization method for four-dimensional motion analysis for cardiac computed tomography

Kidoh

Utsunomiya

Funama

et al. 2017

Journal of Cardiovascular Computed Tomography

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Background Cardiac computed tomography (CT) has the potential for fully four-dimensional (4D for 3D plus time) motion analysis of the heart. We aimed at developing a method for assessment and presentation of the 4D motion for multi-phase, contrast-enhanced cardiac CT data sets and demonstrating its clinical applicability. Methods Four patients with normal cardiac function, old myocardial infarction (OMI), takotsubo cardiomyopathy, and hypertrophic cardiomyopathy (HCM) underwent contrast-enhanced cardiac CT for one heartbeat using a 320-row CT scanner with no tube current modulation. CT images for 10 cardiac phases (with a 10%-increment of the R-R interval) were reconstructed with the isotropic effective resolution of (0.5 mm)3. An image-based motion-estimation (iME) algorithm, developed previously, has been used to estimate a time series of 3D cardiac motion, from the end-systole to the other nine phases. The iME uses down-sampled images with a resolution of (1.0 mm)3, deforms the end-systole images non-rigidly to match images at other phases. Once the agreement is maximized, iME outputs a 3D motion vector defined for each voxel for each phase, that smoothly changes over voxels and phases. The proposed visualization method, which is called “vectors through a cross-sectional image (VCI),” presents 3D vectors from the end-diastole to the end-systole as arrows with an end-diastole CT slice. We performed visual assessment of the VCI with calculated the mean vector lengths to evaluate regional left ventricular (LV) contraction. Results The VCI images showed the magnitude and direction of systolic 3D vectors, including the through-plane motion, and successfully visualized the relations of LV wall segments and abnormal regional wall motion. Decreased regional motion and asymmetric motion due to hypokinetic infarct segment, takotsubo cardiomyopathy, and hyper trophic cardiomyopathy was clearly observed. It was easy to appreciate the relation of the abnormal regional wall motion to the affected LV wall segments. The mean vector lengths of the affected segments with pathologies were clearly smaller than the other unaffected segments (1.2–1.7 mm versus 2.5–4.7 mm). Conclusions VCI images could capture the magnitude and direction of through-plane motion and show the relations of LV wall segments and abnormal wall motion.

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Assessment of isotropic calcium using 0.5-mm reconstructions from 320-row CT data sets identifies more patients with non-zero Agatston score and more subclinical atherosclerosis than standard 3.0-mm coronary artery calcium scan and CT angiography

Cited by 20 publications

References 19 publications

Identifying Small Coronary Calcification in Non-Contrast 0.5-mm Slice Reconstruction to Diagnose Coronary Artery Disease in Patients with a Conventional Zero Coronary Artery Calcium Score

Identifying Small Coronary Calcification in Non-Contrast 0.5-mm Slice Reconstruction to Diagnose Coronary Artery Disease in Patients with a Conventional Zero Coronary Artery Calcium Score

Computed tomography-based calcium scoring in cadaver leg arteries: Influence of dose, reader, and reconstruction algorithm

Vectors through a cross-sectional image (VCI): A visualization method for four-dimensional motion analysis for cardiac computed tomography

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