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High-pitch dual-source CT for coronary artery calcium scoring: A head-to-head comparison of non-triggered chest versus triggered cardiac acquisition.
Metadata
Journaljournal of cardiovascular computed tomography2.892Date
2020 May 12
5 months ago
Type
Journal Article
Volume
2020-May-12 / :
Author
Xia C 1, Vonder M 2, Pelgrim GJ 3, Rook M 4, Xie X 5, Alsurayhi A 6, van Ooijen PMA 7, van Bolhuis JN 8, Oudkerk M 9, Dorrius M 10, van der Harst P 11, Vliegenthart R 12
Affiliation
  • 2. University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands. Electronic address: [email protected]
  • 3. University of Groningen, University Medical Center Groningen, Department of Radiology, Groningen, the Netherlands. Electronic address: [email protected]
  • 4. University of Groningen, University Medical Center Groningen, Department of Radiology, Groningen, the Netherlands; Department of Radiology, Martini Hospital Groningen, Groningen, the Netherlands. Electronic address: [email protected]
  • 5. Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: [email protected]
  • 6. University of Groningen, Faculty of Medical Sciences, Groningen, the Netherlands. Electronic address: [email protected]
  • 7. University of Groningen, University Medical Center Groningen, Department of Radiation Therapy, Groningen, the Netherlands. Electronic address: [email protected]
  • 8. Lifelines Cohort Study, Groningen, the Netherlands. Electronic address: [email protected]
  • 9. University of Groningen, Faculty of Medical Sciences, Groningen, the Netherlands; Institute for Diagnostic Accuracy, Groningen, the Netherlands. Electronic address: [email protected]
  • 10. University of Groningen, University Medical Center Groningen, Department of Radiology, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands. Electronic address: [email protected]
  • 11. University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, the Netherlands. Electronic address: [email protected]
  • 12. University of Groningen, University Medical Center Groningen, Department of Radiology, Groningen, the Netherlands. Electronic address: [email protected]
Doi
PMIDMESH
Abstract
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 (κ = 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˂0.001). Agreement in CAC-based risk strata was excellent (weighted κ = 0.95). Sixty-five cases (6.5%) were reclassified by one risk category in chest CT, with fifty-five (84.6%) shifting downward. Higher BMI resulted in higher reclassification rate (13% for BMI ≥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.
Keywords: Computed tomography Coronary artery calcium score Dual source High pitch
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2.9
J Cardiovasc Comput Tomogrjournal of cardiovascular computed tomography
Metadata
LocationUnited States
FromELSEVIER SCIENCE INC

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