Quantification of coronary artery calcium using ultrafast computed tomography

Abstract

Ultrafast computed tomography was used to detect and quantify coronary artery calcium levels in 584 subjects (mean age 48 +/- 10 years) with (n = 109) and without (n = 475) clinical coronary artery disease. Fifty patients who underwent fluoroscopy and ultrafast computed tomography were also evaluated. Twenty contiguous 3 mm slices were obtained of the proximal coronary arteries. Total calcium scores were calculated based on the number, areas and peak Hounsfield computed tomographic numbers of the calcific lesions detected. In 88 subjects scored by two readers independently, interobserver agreement was excellent with identical total scores obtained in 70. Ultrafast computed tomography was more sensitive than fluoroscopy, detecting coronary calcium in 90% versus 52% of patients. There were significant differences (p less than 0.0001) in mean total calcium scores for those with versus those without clinical coronary artery disease by decade: 5 versus 132, age 30 to 39 years; 27 versus 291, age 40 to 49 years; 83 versus 462, age 50 to 59 years; and 187 versus 786, age 60 to 69 years. Sensitivity, specificity and predictive values for clinical coronary artery disease were calculated for several total calcium scores in each decade. For age groups 40 to 49 and 50 to 59 years, a total score of 50 resulted in a sensitivity of 71% and 74% and a specificity of 91% and 70%, respectively. For age group 60 to 69 years, a total score of 300 gave a sensitivity of 74% and a specificity of 81%. The negative predictive value of a 0 score was 98%, 94% and 100% for age groups 40 to 49, 50 to 59 and 60 to 69 years, respectively. Ultrafast computed tomography is an excellent tool for detecting and quantifying coronary artery calcium.

Extracellular Fluid Excess Is Significantly Associated With Coronary Artery Calcification in Patients With Chronic Kidney Disease

“…Agatston calcium scores were calculated to quantify the extent of CAC. A total CACS of ≥400 was defined as CAC 14, 15…”

Impact of Vascular Hemodynamics on Aortic Stenosis Evaluation: New Insights Into the Pathophysiology of Normal Flow—Small Aortic Valve Area—Low Gradient Pattern

“…Acquisition was triggered by ECG at 60% to 70% of the R‐to‐R‐wave interval. Aortic valve calcification score was measured with the Agatston scoring method using commercially available and validated software (Aquarius iNtuition; TeraRecon Inc, San Mateo, CA) and all aortic valve calcification data were expressed in Agatston units (AU) 25. Calcification was defined as 4 adjacent pixels with a density >130 Hounsfield units.…”

Coronary artery and abdominal aortic calcification are associated with cardiovascular disease in type 2 diabetes

“…A CT volume threshold was utilized for identification of calcific lesions as previously described [23]. Each focus exceeding the minimum volume criteria and having greater than 130 Hounsfield units was scored using the algorithm developed by Agatston et al [24] as previously described [23]. Total coronary or aortic calcium scores were determined by summing individual lesion scores from each of four anatomic sites (left main, left anterior descending, circumflex, and right coronary arteries) or along the scanned region of the aorta, respectively.…”