TY - JOUR
T1 - High-pitch dual-source CT for coronary artery calcium scoring
T2 - A head-to-head comparison of non-triggered chest versus triggered cardiac acquisition
AU - Xia, Congying
AU - Vonder, Marleen
AU - Pelgrim, Gert Jan
AU - Rook, Mieneke
AU - Xie, Xueqian
AU - Alsurayhi, A.
AU - Ooijen, van, Peter
AU - Bolhuis, van, Jurjen
AU - Oudkerk, Matthijs
AU - Dorrius, Monique
AU - Harst, van der, Pim
AU - Vliegenthart, Rozemarijn
N1 - Copyright © 2020 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.
PY - 2021/2
Y1 - 2021/2
N2 - Background: To determine the effect of low-dose, high-pitch non-electrocardiographic (ECG)-triggered chest CT on coronary artery calcium (CAC) detection, quantification and risk stratification, compared to ECG-triggered cardiac CT.Methods: We selected 1,000 participants from the ImaLife study, 50% with coronary calcification on cardiac CT. All participants underwent non-contrast cardiac CT followed by chest CT using third-generation dual-source technology. Reconstruction settings were equal for both acquisitions. CAC scores were determined by Agatston's method, and divided dichotomously (0, > 0), and into risk categories (0, 1-99, 100-399, >_400). We investigated the influence of heart rate and body mass index (BMI) on risk reclassification.Results: Positive CAC scores on cardiac CT ranged from 1 to 6926 (median 39). Compared to cardiac CT, chest CT had sensitivity of 0.96 (95%CI 0.94-0.98) and specificity of 0.99 (95%CI 0.97-0.99) for CAC detection (kappa = 0.95). In participants with coronary calcification on cardiac CT, CAC score on chest CT was lower than on cardiac CT (median 30 versus 40, p= 30 versus 5.2% for BMI < 30, p = 0.001), but there was no effect of heart rate.Conclusion: Low-dose, high-pitch chest CT, using third-generation dual-source technology shows almost perfect agreement with cardiac CT in CAC detection and risk stratification. However, low-dose chest CT mainly underestimates the CAC score as compared to cardiac CT, and results in inaccurate risk categorization in BMI >= 30.
AB - Background: To determine the effect of low-dose, high-pitch non-electrocardiographic (ECG)-triggered chest CT on coronary artery calcium (CAC) detection, quantification and risk stratification, compared to ECG-triggered cardiac CT.Methods: We selected 1,000 participants from the ImaLife study, 50% with coronary calcification on cardiac CT. All participants underwent non-contrast cardiac CT followed by chest CT using third-generation dual-source technology. Reconstruction settings were equal for both acquisitions. CAC scores were determined by Agatston's method, and divided dichotomously (0, > 0), and into risk categories (0, 1-99, 100-399, >_400). We investigated the influence of heart rate and body mass index (BMI) on risk reclassification.Results: Positive CAC scores on cardiac CT ranged from 1 to 6926 (median 39). Compared to cardiac CT, chest CT had sensitivity of 0.96 (95%CI 0.94-0.98) and specificity of 0.99 (95%CI 0.97-0.99) for CAC detection (kappa = 0.95). In participants with coronary calcification on cardiac CT, CAC score on chest CT was lower than on cardiac CT (median 30 versus 40, p= 30 versus 5.2% for BMI < 30, p = 0.001), but there was no effect of heart rate.Conclusion: Low-dose, high-pitch chest CT, using third-generation dual-source technology shows almost perfect agreement with cardiac CT in CAC detection and risk stratification. However, low-dose chest CT mainly underestimates the CAC score as compared to cardiac CT, and results in inaccurate risk categorization in BMI >= 30.
KW - Computed tomography
KW - Coronary artery calcium score
KW - Dual source
KW - High pitch
U2 - 10.1016/j.jcct.2020.04.013
DO - 10.1016/j.jcct.2020.04.013
M3 - Article
C2 - 32505593
VL - 15
SP - 65
EP - 72
JO - Journal of Cardiovascular Computed Tomography
JF - Journal of Cardiovascular Computed Tomography
SN - 1934-5925
IS - 1
ER -