Influence of a small field-of-view size on the detection of coronary artery calcifications with MSCT: in vitro and in vivo study

Abstract

The purpose of this study is to asses the impact of small field-of-view (FOV) sizes on the detection of coronary artery calcifications using multislice-spiral computed tomography (MSCT). First, a static chest phantom containing calcium inserts was scanned 10 times using a standardized scan protocol. Secondly, 50 patients (28 male, 63.6+/-10.6 years) underwent cardiac MSCT using the same protocol. Images were reconstructed with three different FOV sizes (180x180, 220x220, 380x380 mm(2)). Coronary calcium scoring and risk stratification were performed for each image series. In the phantom study, the Agatston score calculated with a FOV size of 180x180 mm(2) was 657.80+/-20.05. At a FOV of 220x220 mm(2) and 380x380 mm(2), the corresponding values were 657.04+/-21.36 and 655.04+/-20.74, respectively. The corresponding values in the patient study were 541.65+/-869.87, 541.91+/-872.57 and 536.61+/-867.81. No statistically significant differences in the calcium score were found comparing different FOV sizes. Significantly more lesions (p=0.00149) were detected in the patient study. Comparing the different FOV sizes of 180x180 mm(2) and 220x220 mm(2) (380x380 mm(2)), four (six) patients had to be assigned to different risk groups. The use of small FOV sizes resulted in an improved detection of coronary calcifications influencing the risk stratification for further cardiac events in MSCT coronary calcium scoring.

Cost effectiveness of coronary angiography and calcium scoring using CT and stress MRI for diagnosis of coronary artery disease

“…The cost for performing calcium scoring using EBT was based on the cost for MSCT coronary calcium scoring, since there is no cost difference between those two methods in the reimbursement system. This also has the advantage of reflecting the clinical ability to perform calcium scoring using MSCT [22][23][24]. Diagnostic accuracy of calcium scoring, however, was based on the results obtained with EBT, since far fewer data are available for MSCT in this regard.…”

Can nontriggered thoracic CT be used for coronary artery calcium scoring? A phantom study

“…The amount of calcium, expressed as Agatston score, 12 was quantified by a software package (Aquarius iNtuition, TeraRecon, Foster City, US), for each calcified lesion, using the widely utilized threshold of 130 HU in nontriggered and ECG-triggered scan. 13 Thresholds from 90 to 160 HU, with steps of 10 HU, were also used in nontriggered scan to analyze the influence of threshold on the agreement of calcium scores between these two techniques. Calcium scores derived from nontriggered thoracic CT examinations with velocities of 0-90 mm/s were considered as index test results, because these velocities were in the common coronary velocity range in a cardiac cycle.…”

Coronary artery calcification on low-dose computed tomography: comparison of Agatston and Ordinal Scores

“…Also, we used a larger field of view than traditionally used for CAC evaluation. However, Hong and colleagues [20] and Mahnken and colleagues [21] had found that variations in the field of view had a negligible effect on CAC Score but found that the use of a larger field of view decreased the sensitivity of detecting small CAC.…”