Low Radiation Dose Calcium Scoring: Evidence and Techniques

Baron, Kaitlin B.; Choi, Andrew; Chen, Marcus Y

doi:10.1007/s12410-016-9373-1

Cited by 54 publications

(30 citation statements)

References 41 publications

(41 reference statements)

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“…Regarding calcifications with HA density of 400 mg/cm 3 , it is suspected that the influences of low intensity (small w i ) and more pixels (large A i ) owing to partial volume effect on Agatston score cancelled each other out, so changing SD value or body size did not cause obvious variation in AS 400HA . By definition, reducing CT number threshold would increase the Agatston score, and vice versa . This phenomenon was also observed in our results, which was adapted to determine the optimal HU threshold for CAC scans undergoing various imaging conditions to ensure the quantification accuracy of calcium scoring from CAC scans reconstructed at 0.5‐mm slice thickness using IR relative to the conventional protocol.…”

Section: Relationship Between Image Quality and Agatston Scoressupporting

confidence: 76%

“…As seen in Fig. , the Agatston scores from 108 IR measurements increased as decreasing kVp, which can be explained by the increase in CT number of calcifications at lower tube voltage . This phenomenon was observed in all calcification densities and was most obvious in the Agatston score of calcifications with HA density of 200 mg/cm 3 .…”

Section: Relationship Between Image Quality and Agatston Scoresmentioning

confidence: 68%

“…Calcified lesions are excluded from the Agatston score if they have an axial area less than 1 mm 2 or a CT number less than the predefined CT number threshold, that is, 130 HU at 120 kVp. It has been reported that lower kVp settings would increase the CT number of calcifications, and thus may result in overestimation of Agatston score . In this study, the CAC scans were acquired not at 120 kVp but also at 100 and 80 kVp.…”

Section: Cac Scoringmentioning

confidence: 99%

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Optimization of HU threshold for coronary artery calcium scans reconstructed at 0.5‐mm slice thickness using iterative reconstruction

Hou

Tsujioka

Yang

2019

J Applied Clin Med Phys

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Purpose This work investigated the simultaneous influence of tube voltage, tube current, body size, and HU threshold on calcium scoring reconstructed at 0.5‐mm slice thickness using iterative reconstruction (IR) through multivariate analysis. Regression results were used to optimize the HU threshold to calibrate the resulting Agatston scores to be consistent with those obtained from the conventional protocol. Methods A thorax phantom set simulating three different body sizes was used in this study. A total of 14 coronary artery calcium (CAC) protocols were studied, including 1 conventional protocol reconstructed at 3‐mm slice thickness, 1 FBP protocol, and 12 statistical IR protocols (3 kVp values*4 SD values) reconstructed at 0.5‐mm slice thickness. Three HU thresholds were applied for calcium identification, including 130, 150, and 170 HU. A multiple linear regression method was used to analyze the impact of kVp, SD, body size, and HU threshold on the Agatston scores of three calcification densities for IR‐reconstructed CAC scans acquired with 0.5‐mm slice thickness. Results Each regression relationship has R2 larger than 0.80, indicating a good fit to the data. Based on the regression models, the HU thresholds as a function of SD estimated to ensure the quantification accuracy of calcium scores for 120‐, 100‐, and 80‐kVp CAC scans reconstructed at 0.5‐mm slice thickness using IR for three different body sizes were proposed. Our results indicate that the HU threshold should be adjusted according to the imaging condition, whereas a 130‐HU threshold is appropriate for 120‐kVp CAC scans acquired with SD = 55 for body size of 24.5 cm. Conclusion The optimized HU thresholds were proposed for CAC scans reconstructed at 0.5‐mm slice thickness using IR. Our study results may provide a potential strategy to improve the reliability of calcium scoring by reducing partial volume effect while keeping radiation dose as low as reasonably achievable.

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Section: Relationship Between Image Quality and Agatston Scoressupporting

confidence: 76%

Section: Relationship Between Image Quality and Agatston Scoresmentioning

confidence: 68%

Section: Cac Scoringmentioning

confidence: 99%

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Optimization of HU threshold for coronary artery calcium scans reconstructed at 0.5‐mm slice thickness using iterative reconstruction

Hou

Tsujioka

Yang

2019

J Applied Clin Med Phys

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“…Estimated radiation doses per one time CAC scan range from 0.8 to 10.5 (median of 2.3) mSv according to a study published in 2009 83) . Recent technical advancements, however, allow for significant reduction in the exposure to a one-time dose of as low as 0.2 mSv, which is lower than those of other screening test, such as mammography for breast cance r (0.7 mSv) or CT-scan for lung cancer (1–2 mSv) 84) . Nevertheless, screening for CAC using computed tomography should also consider the concomitant accumulation of exposures to ionizing radiation from other sources including iatrogenic sources.…”

Section: Other Topicsmentioning

confidence: 99%

Coronary Artery Calcium and Carotid Artery Intima Media Thickness and Plaque: Clinical Use in Need of Clarification

Zaid

Fujiyoshi

Kadota

et al. 2017

J Atheroscler Thromb

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Atherosclerosis begins in early life and has a long latent period prior to onset of clinical disease. Measures of subclinical atherosclerosis, therefore, may have important implications for research and clinical practice of atherosclerotic cardiovascular disease (ASCVD). In this review, we focus on coronary artery calcium (CAC) and carotid artery intima-media thickness (cIMT) and plaque as many population-based studies have investigated these measures due to their non-invasive features and ease of administration. To date, a vast majority of studies have been conducted in the US and European countries, in which both CAC and cIMT/plaque have been shown to be associated with future risk of ASCVD, independent of conventional risk factors. Furthermore, these measures improve risk prediction when added to a global risk prediction model, such as the Framingham risk score. However, no clinical trial has assessed whether screening with CAC or cIMT/plaque will lead to improved clinical outcomes and healthcare costs. Interestingly, similar levels of CAC or cIMT/plaque among various regions and ethnic groups may in fact be associated with significantly different levels of absolute risk of ASCVD. Therefore, it remains to be determined whether measures of subclinical atherosclerosis improve risk prediction in non-US/European populations. Although CAC and cIMT/plaque are promising surrogates of ASCVD in research, we conclude that their use in clinical practice, especially as screening tools for primary prevention in asymptomatic adults, is premature due to many vagaries that remain to be clarified.

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“…Anatomically correct phantoms can be used in determining the effectiveness of new imaging techniques (95). For example, phantoms used in cardiac imaging can help validate the accuracy of CT calcium scoring and determine the need for correction factors when using different reconstruction algorithms (96). …”

Section: Introductionmentioning

confidence: 99%

Clinical Applications of 3D Printing

et al. 2018

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Three-dimensional (3D) printing refers to a number of manufacturing technologies that create physical models from digital information. Radiology is poised to advance the application of 3D printing in health care because our specialty has an established history of acquiring and managing the digital information needed to create such models. The 3D Printing Task Force of the Radiology Research Alliance presents a review of the clinical applications of this burgeoning technology, with a focus on the opportunities for radiology. Topics include uses for treatment planning, medical education, and procedural simulation, as well as patient education. Challenges for creating custom implantable devices including financial and regulatory processes for clinical application are reviewed. Precedent procedures that may translate to this new technology are discussed. The task force identifies research opportunities needed to document the value of 3D printing as it relates to patient care.

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Low Radiation Dose Calcium Scoring: Evidence and Techniques

Cited by 54 publications

References 41 publications

Optimization of HU threshold for coronary artery calcium scans reconstructed at 0.5‐mm slice thickness using iterative reconstruction

Optimization of HU threshold for coronary artery calcium scans reconstructed at 0.5‐mm slice thickness using iterative reconstruction

Coronary Artery Calcium and Carotid Artery Intima Media Thickness and Plaque: Clinical Use in Need of Clarification

Clinical Applications of 3D Printing

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