Spiral versus Electron-Beam CT for Coronary Artery Calcium Scoring

Goldin, Jonathan G.; Yoon, Hyo‐Chun; Greaser, Lloyd E.; Heinze, Stefan; McNitt-Gray, Michael F.; Brown, Matthew S.; Sayre, James W.; Emerick, Aletha; Aberle, Denise R.

doi:10.1148/radiol.2211001038

Cited by 66 publications

(24 citation statements)

References 21 publications

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“…In electron-beam CT, intraobserver and interobserver reliability for CAC has been shown to be small. Apart from the second 2.5-mm prospective scan (scan 2), our results were mostly comparable to those on retrospective ECG-gated single-slice spiral CT [26], although half of the CAC measurements were performed by a less-experienced radiologist (1 year). Fig.…”

Section: Interobserver Variabilitysupporting

confidence: 69%

Variability of repeated coronary artery calcium measurements by 1.25-mm- and 2.5-mm-thickness images on prospective electrocardiograph-triggered 64-slice CT

et al. 2007

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High reproducibility on coronary artery calcium scoring is a key requirement in monitoring the progression of coronary atherosclerosis. The purpose of this prospective study is to assess the reproducibility of 1.25-mm- and 2.5-mm-thickness images on prospective electrocardiograph-triggered 64-slice CT with respect to 2.5-mm-thickness images on spiral overlapping reconstruction. One hundred patients suspected of coronary artery disease were scanned twice repeatedly, both on prospective electrocardiograph-triggered step-and-shoot and retrospective electrocardiograph-gated spiral scans. Using 1.25-mm-thickness collimation, 1.25-mm- and 2.5-mm-thickness image sets on prospective scans and 2.5-mm-thickness image sets with 1.25-mm increment (overlapping) on retrospective scans were obtained. Coronary artery calcium scores, interscan variability and interobserver variability were evaluated. The mean interscan variability in coronary artery calcium measurement on 1.25-mm prospective/2.5-mm prospective/2.5-mm overlapping retrospective scans were Agatston: 10%/18%/12%, volume: 10%/12%/10% and mass: 8%/13%/11% for observer 1 and Agatston: 8%/14%/10%, volume: 7%/9%/10% and mass: 7%/10%/9% for observer 2, respectively. The mean interobserver variability was 5% to 14%. In conclusion, prospective electrocardiograph-triggered 64-slice CT using the 1.25-mm prospective scan shows the lowest variability. The 2.5-mm prospective scan on volume or mass scoring shows variability of around 10%, comparable to 2.5-mm-thickness spiral overlapping reconstruction images.

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Section: Interobserver Variabilitysupporting

confidence: 69%

Variability of repeated coronary artery calcium measurements by 1.25-mm- and 2.5-mm-thickness images on prospective electrocardiograph-triggered 64-slice CT

et al. 2007

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“…Previous attempts at screening have focused mainly on CT [36]. Particularly, the development of multislice CT has given rise to intensive consideration regarding the use of this technology for assessing cardiovascular risks with coronary calcium scoring [37], lung cancer [4,5], as well as colorectal cancer with virtual CT colonography [38]. Recently, even whole-body CT screening is being offered on a commercial basis in the United States.…”

Section: Discussionmentioning

confidence: 99%

MR-based full-body preventative cardiovascular and tumor imaging: technique and preliminary experience

et al. 2004

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Recent improvements in hardware and software, lack of side effects, as well as diagnostic accuracy make magnetic resonance imaging a natural candidate for preventative imaging. Thus, the purpose of the study was to evaluate the feasibility of a comprehensive 60-min MR-based screening examination in healthy volunteers and a limited number of patients with known target disease. In ten healthy volunteers (7 men, 3 women; mean age, 32.4 years) and five patients (4 men, 1 woman; mean age, 56.2 years) with proven target disease we evaluated the performance of a comprehensive MR screening strategy by combining well-established organ-based MR examination components encompassing the brain, the arterial system, the heart, the lungs, and the colon. All ten volunteers and five patients tolerated the comprehensive MR examination well. The mean in-room time was 63 min. In one volunteer, insufficient colonic cleansing on the part of the volunteer diminished the diagnostic reliability of MR colonography. All remaining components of the comprehensive MR examination were considered diagnostic in all volunteers and patients. In the five patients, the examination revealed the known pathologies [aneurysm of the anterior communicating artery ( n=1), renal artery stenosis ( n=1), myocardial infarct ( n=1), and colonic polyp ( n=2)]. The outlined MR screening strategy encompassing the brain, the arterial system, the heart, the lung, and the colon is feasible. Further studies have to show that MR-based screening programs are cost-effective in terms of the life-years saved.

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“…Calcium scores obtained with spiral CT are significantly different than EBT, with a lower sensitivity for calcification. 25,26 …”

Section: Discussionmentioning

confidence: 99%

Continuous Probabilistic Prediction of Angiographically Significant Coronary Artery Disease Using Electron Beam Tomography

et al. 2002

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Background-We sought to incorporate electron beam tomography-derived calcium scores in a model for prediction of angiographically significant coronary artery disease (CAD). Such a model could greatly facilitate clinical triage in symptomatic patients with no known CAD. Methods and Results-We examined 1851 patients with suspected CAD who underwent coronary angiography for clinicalindications. An electron beam tomographic scan was performed in all patients. Total per-patient calcium scores and separate scores for the major coronary arteries were added to logistic regression models to calculate a posterior probability of the severity and extent of angiographic disease. These models were designed to be continuous, adjusted for age and sex, corrected for verification bias, and independently validated in terms of their incremental diagnostic accuracy. The overall sensitivity was 95%, and specificity was 66% for coronary calcium to predict obstructive disease on angiography. With calcium scores Ͼ20, Ͼ80, and Ͼ100, the sensitivity to predict stenosis decreased to 90%, 79%, and 76%, whereas the specificity increased to 58%, 72%, and 75%, respectively. The logistic regression model exhibited excellent discrimination (receiver operating characteristic curve area, 0.842Ϯ0.023) and calibration ( 2 goodness of fit, 8.95; Pϭ0.442). Conclusions-Electron beam tomographic calcium scanning provides incremental and independent power in predicting the severity and extent of angiographically significant CAD in symptomatic patients, in conjunction with pretest probability of disease. This algorithm is most useful when applied to an intermediate-risk population.

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Spiral versus Electron-Beam CT for Coronary Artery Calcium Scoring

Abstract: Spiral CT has not yet proved to be a feasible alternative to electron-beam CT for coronary artery calcium quantification. There are systematic differences between calcium scores obtained with single-detector array subsecond spiral CT and those obtained with electron-beam CT.

Cited by 66 publications

References 21 publications

Variability of repeated coronary artery calcium measurements by 1.25-mm- and 2.5-mm-thickness images on prospective electrocardiograph-triggered 64-slice CT

Variability of repeated coronary artery calcium measurements by 1.25-mm- and 2.5-mm-thickness images on prospective electrocardiograph-triggered 64-slice CT

MR-based full-body preventative cardiovascular and tumor imaging: technique and preliminary experience

Continuous Probabilistic Prediction of Angiographically Significant Coronary Artery Disease Using Electron Beam Tomography

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