Comparison of dual-source and electron-beam CT for the assessment of coronary artery calcium scoring

Abstract

Objective: Cardiac CT allows the detection and quantification of coronary artery calcification (CAC). Electron-beam CT (EBCT) has been widely replaced by high-end CT generations in the assessment of CAC. The aim of this study was to compare the CAC scores derived from an EBCT with those from a dual-source CT (DSCT). Methods: We retrospectively selected 92 patients (61 males; mean age, 60.7¡12 years) from our database, who underwent both EBCT and DSCT. CAC was assessed using the Agatston score by two independent readers (replicates: 1, 2; 35mean of reading 1 and 2). Results: EBCT scores were on average slightly higher than DSCT scores (281¡569 vs 241¡502; p,0.05). In regression analysis R Cardiac CT allows the detection and quantification of coronary artery calcification (CAC) and may thus add important in vivo information on the path from risk factor exposure to formation of clinical events [1][2][3][4]. Because of its advantages of being a fast technique with limited radiation exposure to the patients, various published clinical outcome data from CAC are based on electronbeam CT (EBCT), and therefore cut-points have been established for EBCT scans. However, since the appearance of newer generations of CT scanners such as dualsource CT (DSCT), scanners of this type are also widely used for CAC scoring as an alternative to EBCT. The spatial resolution of DSCT scanners is much higher, enabling the detection of smaller lesions, and DSCT is more applicable to other radiological procedures such as CT angiography [5]. CAC scoring is performed on these newer scanner generations using the Agatston score algorithm as the standard measure of CAC quantification. There is direct comparison of CAC scores between newer scanners and EBCT [6][7][8][9]. However, comparison between EBCT and DSCT is rare [10]. This is of interest for firsttime CAC scoring in asymptomatic subjects, and especially for evaluation of disease progression in subjects with prior EBCT testing. Therefore, the aim of this study was to evaluate the diagnostic accuracy of DSCT in the detection of CAC scores to EBCT. In addition, we compared techniques with each other, verifying the ability of CAC score classification. Methods and materials ParticipantsBetween September 2006 and February 2008 we selected participants from our database who had undergone DSCT coronary angiography for clinical evaluation of suspected coronary heart disease and who had recent EBCT scans for cardiovascular risk stratification. As part of the DSCT protocol, a prospectively gated non-contrast scan was performed. All patients were selected retrospectively. We did not collect any data prospectively. According to the clinical presentation, patients indicating a low pre-test likelihood of having a significant coronary artery stenosis were referred for coronary CT angiography instead of invasive coronary angiogram, just as those with a high pre-test likelihood of having

Progression of coronary artery calcification seems to be inevitable, but predictable - results of the Heinz Nixdorf Recall (HNR) study

“…The CT scans were repeated with the same system and protocol, so that we avoided the use of any correction factors, which otherwise would have been needed using different types of scanners. 14 , 25 , 32 A 5-year follow-up period may be too short, but may allow an extrapolation to longer time intervals based on the exponential percentile curvature, which remained constant over time. In addition, we found for some patient, for whom we had during a 10-year follow-up multiple CT scans, that their individual CAC progression followed the age- and gender-related exponential curvature calculated form our baseline data of the total cohort.…”

A pooled-analysis of age and sex based coronary artery calcium scores percentiles

“…Calcium scores might be underestimated by MDCT, 26 and particularly in obese patients. 27 However, other studies have shown that CAC scores are comparable between EBCT and MDCT [28][29][30][31] and for that matter the MESA calculator combined the CAC scores derived with both types of scanners. 32 Finally, we had to exclude 3 studies, the MESA, the study by Hopkins et al and the study by Park et al, 9,12,13 since they used 10-year age strata instead of 5-year strata as we did.…”

Increased discordance between HeartScore and coronary artery calcification score after introduction of the new ESC prevention guidelines

“…Finally, prospective trials which measure CAC and delineate the consequences in primary prophylaxis are needed. In the study, the CAC score was measured by the use of different CT-scanners (EBCT versus MSCT), but these two techniques are considered as equal in measuring the CAC score [28,29].…”