Coronary calcium screening with dual-source CT: reliability of ungated, high-pitch chest CT in comparison with dedicated calcium-scoring CT

Hutt, Antoine; Duhamel, Alain; Deken, Valérie; Faivre, J; Molinari, Francesco; Rémy, Jacques; Rémy-Jardin, M.

doi:10.1007/s00330-015-3978-7

Cited by 34 publications

(31 citation statements)

References 26 publications

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“…Prior results have shown good correlation of the calcium score on non-gated CT compared to dedicated ECG gated calcium CT scoring 2, 20 . Although a high calcium score is predictive of coronary artery disease, the calcium score is understood as a marker of disease, rather than direct visualization of coronary stenosis.…”

Section: Discussionmentioning

confidence: 95%

High pitch third generation dual-source CT: Coronary and cardiac visualization on routine chest CT

Sandfort

Ahlman

Selwaness

et al. 2016

Journal of Cardiovascular Computed Tomography

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Background Chest CT scans are frequently performed in radiology departments but have not previously contained detailed depiction of cardiac structures. Objectives To evaluate myocardial and coronary visualization on high-pitch non-gated CT of the chest using 3rd generation dual-source computed tomography (CT). Methods Cardiac anatomy of patients who had 3rd generation, non-gated high pitch contrast enhanced chest CT and who also had prior conventional (low pitch) chest CT as part of a chest abdomen pelvis exam was evaluated. Cardiac image features were scored by reviewers blinded to diagnosis and pitch. Paired analysis was performed. Results 3862 coronary segments and 2220 cardiac structures were evaluated by two readers in 222 CT scans. Most patients (97.2%) had chest CT for oncologic evaluation. The median pitch was 2.34 (IQR 2.05, 2.65) in high pitch and 0.8 (IQR 0.8, 0.8) in low pitch scans (p<0.001). High pitch CT showed higher image visualization scores for all cardiovascular structures compared with conventional pitch scans (p<0.0001). Coronary arteries were visualized in 9 coronary segments per exam in high pitch scans versus 2 segments for conventional pitch (p<0.0001). Radiation exposure was lower in the high pitch group compared with the conventional pitch group (median CTDIvol 10.83 vs. 12.36 mGy and DLP 790 vs. 827 mGycm respectively, p <0.01 for both) with comparable image noise (p=0.43). Conclusion Myocardial structure and coronary arteries are frequently visualized on non-gated 3rd generation chest CT. These results raise the question of whether the heart and coronary arteries should be routinely interpreted on routine chest CT that is otherwise obtained for non-cardiac indications.

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Section: Discussionmentioning

confidence: 95%

High pitch third generation dual-source CT: Coronary and cardiac visualization on routine chest CT

Sandfort

Ahlman

Selwaness

et al. 2016

Journal of Cardiovascular Computed Tomography

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“…However, recent studies have shown a strong correlation between gated and nongated scans, and CAC measured on nongated scans has been shown to be independently associated with clinical outcomes. 11,31,32 It is possible that some events were not captured on follow-up, but this bias would likely affect both scores equally because the scores were estimated in the same participants. The study also has a number of strengths.…”

Section: Discussionmentioning

confidence: 99%

Visual Estimate of Coronary Artery Calcium Predicts Cardiovascular Disease in COPD

Bhatt

Kazerooni

Newell

et al. 2018

Chest

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“…Findings were similar in the National Lung Screening Trial (NLST) of 1575 CT scans [16]. In another study, the sensitivity and specificity of routine chest CT scanning for detecting positive CAC scores were 96.4 % and 100 %, respectively [17]. Nonetheless, the use of CAC in assessing cardiac risk in cancer patients having undergone cancer therapy, is unknown.…”

Section: Introductionmentioning

confidence: 77%

A comparative assessment of coronary artery calcification on chest CT scans of patients referred to a cardio-oncology clinic

et al. 2016

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Background: The presence and burden of coronary artery calcium (CAC) is a strong predictor of cardiovascular events. In an effort to gain insight into the utility of CAC for coronary artery disease (CAD) screening in cancer patients with heart disease, we sought to determine the presence and burden of CAC detected on routine chest CT in patients referred to a cardio-oncology clinic, comparing them to a conventional cardiology clinic with the general population as controls. Methods: Patients from the cardio-oncology clinic, general cardiology clinic, and the general clinic population at Rush University Medical Center who had a chest CT as part of their previous treatment were identified. Each CT scan was evaluated for presence, extent, and severity of CAC by 3 independent readers. Results: In multivariate analysis, when compared with cardio-oncology clinic, CAC was more prevalent in the CT scans of cardiology patients (p = 0.04), but not the general clinic population (p = 0.5); CAC extent (p = 0.05) and severity (p = 0.05) was significantly higher in the cardiology patients but the extent (p = 0.05) and severity (p = 0.92) was similar in the general clinic population. Conclusion: Despite being matched by age and sex, controlling for other major cardiovascular risk factors, patients referred to our cardio-oncology clinic had similar and less prevalent/severe CAC burden compared with the general population and conventional cardiology clinics respectively. Whether this translates to less utility of CAC for CAD screening, or to less overall coronary events in a cardio-oncology clinic, is of interest.

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Coronary calcium screening with dual-source CT: reliability of ungated, high-pitch chest CT in comparison with dedicated calcium-scoring CT

Cited by 34 publications

References 26 publications

High pitch third generation dual-source CT: Coronary and cardiac visualization on routine chest CT

High pitch third generation dual-source CT: Coronary and cardiac visualization on routine chest CT

Visual Estimate of Coronary Artery Calcium Predicts Cardiovascular Disease in COPD

A comparative assessment of coronary artery calcification on chest CT scans of patients referred to a cardio-oncology clinic

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