Automatic Assessment of Coronary Artery Calcium Score from Contrast-Enhanced 256-Row Coronary Computed Tomography Angiography

Rubinshtein, Ronen; Halon, David A.; Gaspar, Tamar; Lewis, Basil S.; Peled, Nir

doi:10.1016/j.amjcard.2013.08.036

Cited by 7 publications

(8 citation statements)

References 18 publications

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“…Therefore, we sought a cutoff value in contrast-enhanced CT images that best corresponded to the non-contrast-enhanced cutoff value for calcium (130 HU). Several studies have shown that coronary calcium scores derived from contrast-enhanced CT images correlate well with those of non-contrast-enhanced CT. 13,14 In those studies, the cutoff value of 320 HU defined coronary calcium on contrast-enhanced CT images. In our study, the threshold for TAC was 250 HU.…”

Section: Discussionmentioning

confidence: 99%

Semiquantitative assessment of tibial artery calcification by computed tomography angiography and its ability to predict infrapopliteal angioplasty outcomes

Kang

Lee

Choi

et al. 2016

Journal of Vascular Surgery

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Section: Discussionmentioning

confidence: 99%

Semiquantitative assessment of tibial artery calcification by computed tomography angiography and its ability to predict infrapopliteal angioplasty outcomes

Kang

Lee

Choi

et al. 2016

Journal of Vascular Surgery

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“…However, the clinical value of deriving the calcium scores from only contrast CT images still needs to be studied. 20,21 Most of the above mentioned methods performed calcium scoring fully automatically while additional user-interactions were needed in three methods. 7,8,17 As a noncontrast cardiac CT scan is routinely accompanied with a contrast cardiac CT scan in many medical centers, in this paper, an automatic coronary calcium scoring algorithm was developed using these two image sets from the same patient.…”

Section: Introductionmentioning

confidence: 99%

Automatic coronary calcium scoring using noncontrast and contrast CT images

et al. 2016

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“…The sample sizes of these studies were small and larger studies will be required to prove their efficacy. A recent study used automated software to create virtual unenhanced images using multiple parameters from CCTA and applied the Agatston score that showed strong correlation with the conventional Agatston score from non-contrast CT [11]. However, at present there is no software program approved for clinical practice that can perform CAC scoring on a CCTA study.…”

Section: Discussionmentioning

confidence: 99%

“…on the non-contrast study to determine a density as calcification. Attempts to separate calcium from the contrast filled vessel lumen on CCTA have been made in the past using different techniques [6][7][8][9][10][11]. These methods are time consuming and reproducibility of the results is low.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Visual Scoring of Coronary Artery Calcium (CAC) on Coronary Computed Tomography Angiogram (CCTA) to Agatston Score

Sonavane¹,

Terry²,

Fineberg³

et al. 2015

J Heart Circ

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Purpose: Detection and quantification of coronary artery calcium (CAC) has a prognostic value for future cardiovascular events, beyond that accrued from other cardiovascular risk factors. CAC is conventionally measured as an Agatston score from an EKG-gated non-contrast CT of the heart using special software. The predominant indication for coronary CT angiography (CCTA) in clinical practice is to evaluate obstructive coronary artery disease (CAD) in a low to intermediate pretest probability population. At present there is no commercially available software for CAC measurement on CCTA scans. The purposes of this study were twofold. First, the study examines the correlation of estimated CAC from CCTA, using a novel method of visual scoring on the CCTA exam and comparing with the measured Agatston score from a non-contrast CAC score scan. Second, the study evaluates the performance of such estimation of CAC across radiologists with varying degrees of experience. Methods:Two cardiac radiologists and a chest radiologist, with varying degrees of experience, evaluated 100 coronary CT angiograms for visual scoring of CAC. The three major coronary vascular segments; left anterior descending artery (LAD) including left main coronary artery (LM), left circumflex coronary artery (LCX) and right coronary artery (RCA) were examined and scored for linear extent (0-4) as well as thickness (0-3). The linear and thickness scores for each segment was multiplied to get a vessel score (0-12) and total CAC score was derived by adding all the vessel scores (0-36). Statistical analysis was performed using Kappa statistic and Spearman Rank Correlation for the agreement with the Agatston scores from non contrast EKG gated calcium score CT scans performed at the same time as the CCTA. The scores of the senior cardiac radiologist with 30 years of experience were used for the primary analysis and the readings from the other two radiologists were used to calculate the inter-reader variability.Results: Overall, 59 % and 57 % of patients had CAC detected by Agatston score and visual score respectively. CAC by visual score on CCTA strongly correlated with the Agatston score (Spearman correlation coefficient 0.88, P < 0.001). In 7 cases visual scoring failed to detect minimal CAC with low Agatston CAC score (mean 4.1, range 1-13). Visual score of > 7 identified CAC > 100 with an area under the curve of 0.965, sensitivity of 0.88 and a specificity of 0.92. A visual score of > 12 identified CAC > 300 with an area under the curve of 0.970, sensitivity of 0.95 and specificity of 0.90. The inter-reader agreement with the other cardiac and chest radiologist was high, with Spearman correlation coefficients of 0.90 & 0.91 (p < 0.001). Conclusion:The visual estimation and stratification of CAC on CCTA is feasible and correlates well with the Agatston score and shows good inter-reader correlation. This additional information from CCTA will be useful for cardiovascular risk stratification and management.

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Automatic Assessment of Coronary Artery Calcium Score from Contrast-Enhanced 256-Row Coronary Computed Tomography Angiography

Cited by 7 publications

References 18 publications

Semiquantitative assessment of tibial artery calcification by computed tomography angiography and its ability to predict infrapopliteal angioplasty outcomes

Semiquantitative assessment of tibial artery calcification by computed tomography angiography and its ability to predict infrapopliteal angioplasty outcomes

Automatic coronary calcium scoring using noncontrast and contrast CT images

Comparison of Visual Scoring of Coronary Artery Calcium (CAC) on Coronary Computed Tomography Angiogram (CCTA) to Agatston Score

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