Reproducibility of coronary calcium quantification in repeat examinations with retrospectively ECG-gated multisection spiral CT

Ohnesorge, Bernd; Flohr, Thomas; Fischbach, Roman; Af, Kopp; Knez, Andreas; Schröder, Stephen; Uj, Schöpf; Crispin, Alexander; Klotz, Ernst; Reiser, Morton F.; Becker, Christoph R.

doi:10.1007/s00330-002-1394-2

Cited by 174 publications

(92 citation statements)

References 16 publications

(25 reference statements)

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“…The mean percentage interscan variability was 30Ϯ31% with the use of an image reconstruction window of 40%, 33Ϯ37% with use of an image reconstruction window of 50%, and 27Ϯ22% with use of the optimal image reconstruction window. The authors stated, "Although we used the same technique as that of Ohnesorge et al, 69 we found mean interscan variability values that were 2 to 3 times higher. No obvious explanation can be given for these striking differences.…”

Section: Reproducibility and Validity Of Calcium Scoringmentioning

confidence: 83%

Assessment of Coronary Artery Disease by Cardiac Computed Tomography

Budoff¹,

Achenbach²,

Blumenthal³

et al. 2006

Circulation

1,226

382

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Section: Reproducibility and Validity Of Calcium Scoringmentioning

confidence: 83%

Assessment of Coronary Artery Disease by Cardiac Computed Tomography

Budoff¹,

Achenbach²,

Blumenthal³

et al. 2006

Circulation

1,226

382

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“…Although the usefulness of CS with regard to risk stratification has been proven in a number of studies [1][2][3], the optimal CT scanning protocols are still a matter of discussion [6,7,[29][30][31][32][33]. Some authors have demonstrated the best reproducibility for the retrospective ECG-gating technique [13,15,30].…”

Section: Discussionmentioning

confidence: 99%

Radiation dose values for various coronary calcium scoring protocols in dual-source CT

Stolzmann

Leschka

Betschart

et al. 2008

Int J Cardiovasc Imaging

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Purpose The purpose of this study was to assess the radiation dose and associated image noise of previously suggested calcium scoring protocols using dual-source CT. Methods One hundred consecutive patients underwent coronary calcium scoring using dual-source CT. Patients were randomly assigned to five different protocols: retrospective ECG-gating and tube current reduction to 4% outside the pulsing window at 120 (protocol A) and 100 kV (B), prospective ECG-triggering at 120 (C) and 100 kV (D), and prospective ECG-triggering at 100 kV with attenuation-based tube current modulation (E). Radiation dose parameters and image noise were determined and compared. Results Protocol A resulted in an effective dose of 1.3 ± 0.2 mSv, protocol B in 0.8 ± 0.2 mSv, protocol C in 1.0 ± 0.2 mSv, protocol D in 0.6 ± 0.1 mSv, and protocol E in 0.7 ± 0.1 mSv. Effective doses were significantly lower (P \ 0.001) with 100 kV when compared to 120 kV protocols, and were significantly lower (P \ 0.001) for prospective versus retrospective ECG-gating. No significant difference was found between protocol D and E. Significant negative correlations were found between the CTDI vol and heart rate for both retrospective ECGgating protocols (protocol A: r = -0.98, P \ 0.001; protocol B: r = -0.83, P \ 0.001). The mean image noise was 29.0 ± 6.7 HU, with no significant differences between the five protocols. The image noise was significantly correlated with the body weight (r = 0.21, P \ 0.05) and BMI (r = 0.31, P \ 0.01). Conclusions Effective dose of calcium scoring using dual-source CT ranges from 0.6 to 1.3 mSv. Prospective triggering and lower tube voltage significantly reduces the radiation but yield similar image noise.

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“…CAC measurement can be completed within 15 minutes with only a few seconds of scanning time and without the need for intravenous contrast. The technique has been validated without the need for heart rate control [31][32][33] and uses a relatively low-effective radiation dose in the 1.0 to 1.8 mSv range. It is considered a mature technology.…”

Section: Description Of the Technologymentioning

confidence: 99%

Atherosclerosis Imaging

Kaul

Douglas

2009

Circ: Cardiovascular Imaging

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Despite the epidemiological insights from the Framingham Study 1 in the early 1950s and the resulting significant advances in the diagnosis and management of coronary heart disease (CHD), it remains the leading cause of death in the United States. In part, this is because sudden cardiac death is the first presentation of CHD in 50% of men and 64% of women 2,3 and, therefore, the only available strategy for reducing mortality in these patients is primary prevention. This is the target population for atherosclerosis imaging, which has been proposed as a strategy for the earlier and more accurate identification of individuals at risk for CHD so that lifesaving preventive strategies can be more optimally targeted in those at risk. Limitations of Current Primary Risk Assessment StrategiesCurrent guidelines for primary prevention recommend initial assessment and risk stratification based on traditional risk factors (eg, the Framingham Risk Score [FRS] in the United States and the Systemic Coronary Risk Evaluation in Europe), followed by goal-directed therapy as necessary to modify those risk factors. 4 However, these traditional prevention strategies can be inadequate, as cardiovascular events do occur in patients without known risk or in low and intermediate risk groups in whom an aggressive treatment strategy would not be indicated. This is highlighted by a study of 222 young adults (men Յ55 years and women Յ65 years) without known prior CHD, hospitalized for acute myocardial infarction, of whom 70% were in a low-risk category with a 10-year risk of CHDϽ10% based on their FRS. 5 Furthermore, when the 10-year risk of these patients was stratified by number of risk factors and low-density lipoprotein cholesterol level, three quarters did not meet National Cholesterol Education Program III criteria 6 to be identified as at sufficient risk to qualify for cholesterol lowering therapy. Part of the reason why FRS fails to detect risk may be its development in an almost entirely white population such that the risk prediction algorithm may not fit other populations as well. 7 Furthermore, the model ignores several major risk factors including diabetes, family history sedentary lifestyle and obesity.

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Reproducibility of coronary calcium quantification in repeat examinations with retrospectively ECG-gated multisection spiral CT

Cited by 174 publications

References 16 publications

Assessment of Coronary Artery Disease by Cardiac Computed Tomography

Assessment of Coronary Artery Disease by Cardiac Computed Tomography

Radiation dose values for various coronary calcium scoring protocols in dual-source CT

Atherosclerosis Imaging

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