Coronary artery calcium: Alternate methods for accurate and reproducible quantitation

Yoon, Hyo‐Chun; Greaser, Lloyd E.; Mather, Richard T.; Sinha, Shantanu; McNitt-Gray, Michael F.; Goldin, Jonathan G.

doi:10.1016/s1076-6332(97)80137-7

Cited by 104 publications

(55 citation statements)

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“…The variability of Agatston scores using electron beam CT yields 20 to 37% [4,9,19,22]. Although the temporal resolution of MDCT is lower than that of electron beam CT, MDCT with overlapping image reconstruction shows a lower variability of 12% compared with 23% with nonoverlapping [16] and 13% compared with 22% [23].…”

Section: Discussionmentioning

confidence: 99%

“…The factors reported to influence inter-scan variability on CAC measurement are as follows; partial volume effect [3], the use of the step function in the Agatston method to quantitate calcium [4], coronary artery motion [5], image noise [6], field inhomogeneity [7], lack of calibration [8], total volume of CAC [9], scoring parameters [10], intraobserver and interobserver variations [11], etc. Other details concerning the factors above are as follows: The use of a continuous weighting function instead of the step function decreases the variability.…”

Section: Introductionmentioning

confidence: 99%

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The impact of motion artifacts on the reproducibility of repeated coronary artery calcium measurements

et al. 2006

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The purpose of this study is, using a 16-section multidetector-row helical computed tomography (MDCT) scanner with retrospective reconstruction, to compare variability in repeated coronary calcium scoring and qualitative scores of the motion artifacts. One hundred forty-four patients underwent two subsequent scans using MDCT. According to Agatston and volume algorithms, the coronary calcium scores during mid-diastole (the center corresponding to 70% of the R-R cycle) were calculated and the inter-scan variability was obtained. Motion artifacts from coronary artery calcium were subjectively evaluated and classified using a 5-point scale: 1, excellent; no motion artifacts; 2, fine, minor motion artifacts; 3, moderate, mild motion artifacts; 4, bad, severe motion artifacts; 5, poor, doubling or discontinuity. Each reading was done by vessels (left main, left descending, left circumflex and right coronary arteries) and the motion artifact score (mean of the scales) was determined per patient. The variability in the low (1.2+/-0.2) and high (2.4+/-0.6) motion artifact score groups was 7+/-6 (median, 6)% and 19+/-15 (16)% on the Agatston score (P<0.01) and 7+/-7 (6)% and 16+/-13 (14)% on the volume score (P<0.01), respectively. In conclusion, motion has a significant impact on the reproducibility of coronary calcium scoring.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The impact of motion artifacts on the reproducibility of repeated coronary artery calcium measurements

et al. 2006

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“…Factors influencing inter-scan variability on CAC measurement reported are as follows: partial volume effect [10], the use of the step function in the Agatston method to quantitate calcium [11], coronary artery motion [12], image noise [13], field inhomogeneity [7], lack of calibration [14], total volume of CAC [15], scoring parameters [16], etc. In the current study, factors contributing to improving measurement accuracy on spiral CT are thinner slice thickness and use of retrospective spiral ECG-gated scan.…”

Section: Discussionmentioning

confidence: 99%

Electron beam CT versus 16-slice spiral CT: how accurately can we measure coronary artery calcium volume?

et al. 2005

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The purpose of this study was to investigate how accurately CAC volume we can be measured using electron beam computed tomography (CT) and 16-slice spiral CT. CAC models with known volume attached to a cardiac phantom were scanned. The error of measurement, variability between measured and real volumes, and inter-scan measurement variability were obtained. For spiral CT, seven different parameters were included: (1) slice thickness (0.625 mm, 1.25 mm and 2.5 mm), (2) retrospective spiral electrocardiograph (ECG)-gated or prospective axial ECG-triggering, (3) overlapping or non-overlapping. The error of measurement was 15% on electron beam CT and 8-20% on spiral CT. CAC volumes were underestimated in 92% and overestimated in 8% of the electron beam CT scans. Volumes were underestimated in 79%, correct in 5% and overestimated in 16% of the spiral CT scans. The best measurement and the least variability was observed on 0.625-mm retrospective spiral ECG-gated CT (error of 8%), a significant result (t-test: P<0.01) when compared with electron beam CT. CAC volume measurement on CT scanners may be significantly different and often underestimates the real volume of CAC. For precise evaluation of CAC volume, thin-slice retrospective spiral ECG-gated scan using a spiral CT scanner is desirable.

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“…In contrast to that, inter-examination reproducibility of the calcium score based on the Agatston method is known to be reduced by partial volume effects and ECG misregistration [16]. In the literature, different authors calculated a variability of 29 % [17], 37.2 % [18], and 46 % [19] for repeated coronary calcium scanning with the EBCT. The inter-modality variability for EBCT TCS and SEQ TCS reported in this study is 42 % ± well within the EBCT interexamination variability reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

Detection and quantification of coronary artery calcification with electron-beam and conventional CT

et al. 1999

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To identify patients with increased risk of having coronary artery disease (CAD), electron-beam computed tomography (EBCT) was used for years for quantifying calcifications of the coronary arteries. The first direct comparison between EBCT and conventional CT was performed to determine the reliability of widely available conventional CT for the assessment of the coronary calcium score. Fifty male patients with suspected CAD were investigated with both modalities, EBCT and conventional 500-ms non-spiral partial scan CT. Scoring of the coronary calcification was performed according to the Agatston method. Forty-two of these patients underwent coronary angiography for the assessment of significant luminal narrowing. The correlation coefficient of the score values of both modalities was highly significant (r = 0.982, p < 0.001). The variability between the two modalities was 42%. Mean calcium score in patients with significant coronary luminal narrowing (n = 37) was 1104 +/- 1089 with EBCT and 1229 +/- 1327 with conventional CT. In patients without luminal narrowing (n = 5) mean calcium score was 73 +/- 57 with EBCT and 26 +/- 35 with conventional CT. Although images of the heart from conventional CT may suffer from cardiac motion artifacts, conventional CT has the potential to identify patients with CAD with accuracy similar to EBCT.

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Coronary artery calcium: Alternate methods for accurate and reproducible quantitation

Cited by 104 publications

References 0 publications

The impact of motion artifacts on the reproducibility of repeated coronary artery calcium measurements

The impact of motion artifacts on the reproducibility of repeated coronary artery calcium measurements

Electron beam CT versus 16-slice spiral CT: how accurately can we measure coronary artery calcium volume?

Detection and quantification of coronary artery calcification with electron-beam and conventional CT

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