Recommendations for Standardization of EBT and MSCT Scanning

Achenbach, Stephan; Daniel, Werner G.; Moshage, Werner

doi:10.1007/pl00002030

Cited by 12 publications

(3 citation statements)

References 23 publications

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“…Hemodynamically relevant stenoses also were detected with only 72.2% sensitivity. Four of the five missed stenoses were either located within small segments or were hidden by heavy calcifications: a possible explanation why our results were worse than those reported by other authors (Table 4) [18,28,29,30,31,32], who either concentrated on the proximal and medial coronary artery segments or excluded heavy calcified segments from evaluation; however, by combining calcium scoring and computerized coronary angiography sensitivity of MDCTA was augmented to 83% (Fig. 2).…”

Section: Discussioncontrasting

confidence: 80%

Multidetector-row cardiac CT: diagnostic value of calcium scoring and CT coronary angiography in patients with symptomatic, but atypical, chest pain

et al. 2004

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The aim of this study was to investigate the accuracy of multidetector-row cardiac CT (MDCT), calcium scoring (Ca-Sc), and MDCT coronary angiography (MD CTA) in the assessment of coronary atherosclerosis. Thirty-eight patients underwent invasive coronary angiography (CA) and MDCT (collimation 4x1 mm, pitch 1.5 mm, TI 500 ms, 120 kV, 300 mAs, and retrospective ECG-gating). Calcium scoring was calculated for the total coronary artery territory and for RCA, LCA, and LCX separately. The MD CTA served to assess the degree and the localization of stenoses. All findings were compared to invasive coronary angiography. Approximately 68.4% (390 of 570) of all coronary segments could be visualized by MDCT. Correlation coefficient for MD CTA and CA amounted to r=0.58, showing distinct differences for the individual segments. Proximal segments generally showed better correlation (range 0.81-0.77) than medial segments (range 0.91-0.20), distal segments (range 0.55-0.04), or side branches (range 0.76-0.00). Patients with hemodynamically relevant (>75%) stenoses were detected by MD CTA with 72.2% sensitivity (13 of 18) and 100% specificity (20 of 20). For Ca-Sc sensitivity ranged between 94.7% (17 of 18) and 66.7% (12 of 18), specificity between 20% (4 of 20) and 80% (16 of 20) respectively, depending on the prevailing cutoff value. Combination of both methods led to 83.3% sensitivity (15 of 18) and 100% specificity (20 of 20), reaching no level of significance as compared with Ca-Sc (p=0.73) or MD CTA (p=0.23) alone. Calcium scoring as a single method showed highest sensitivity in the detection of coronary atherosclerosis but at the expense of low specificity. In patients with no or moderate calcifications, combination with MD CTA helped to distinctly increase specificity and NPV.

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Section: Discussioncontrasting

confidence: 80%

Multidetector-row cardiac CT: diagnostic value of calcium scoring and CT coronary angiography in patients with symptomatic, but atypical, chest pain

et al. 2004

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“…The same generation scanner should be used Heart-rate (HR) should be acceptable Mass equivalent should be used for subsequent followup Exclude pericardial and/or mitral valve calcifi cation [Figure 4] The AHA Writing Group proposes that the following minimum requirements be met in scanning for CS: [33] 1. Use of an electron beam scanner or a 4-level (or greater)…”

Section: How Good Is the Reliability And Reproducibility Of Results O...mentioning

confidence: 99%

“…The International Consortium for the Standardization of Cardiac CT revealed that MSCT is an equal and potentially superior cardiac imaging modality compared to EBCT. [33] Increased temporal resolution and reduction in slice thickness improve CS results. In a two-year prospective study [34] of 1173 asymptomatic patients without documented CAD, CS was measured by EBCT and found to be predictive of CAD events.…”

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Coronary calcium score: An Indian scenario and experience

Telkar¹

2007

Indian J Radiol Imaging

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Detektion von Koronarkalk mit der Mehrschicht-Spiral-Computertomographie: Eine Alternative zur Elektronenstrahltomographie

Knez¹,

Becker

Becker³

et al. 2002

Z Kardiol

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Electron-beam CT (EBT) has been used for years as the gold standard to quantify coronary artery calcification as a marker of coronary atherosclerosis. With the introduction of Multi-Slice Spiral CT (MSCT) technology in 1999, EBT is now challenged in the determination of coronary calcium. The aim of this study was to determine the diagnostic accuracy of MSCT for the assessment of coronary calcium, comparing this new technique to EBT. The study population consisted of 54 male patients, aged 58 +/- 11 years with suspected coronary artery disease. For EBT, 40 axial slices (scan time = 100 ms, slice thickness = 3 mm) were acquired in one breath-hold (35 +/- 5 s) using an ECG-trigger at 80% of the RR interval. For MSCT, simultaneous acquisition of four axial slices (scan time = 250 ms, slice thickness = 2.5 mm) allowed the entire heart (40 slices) to be covered in one breath-hold (25 +/- 5 s) using a prospective ECG-trigger (R--450 ms). For quantification of coronary calcium the Agatston and the Volumetric calcium score (VCS) were applied. Mean Agatston score of the study group was calculated as 88 +/- 111 (median = 45), which is between the 25th and 75th age-corrected percentile of asymptomatic patients. For the Volumetric calcium score, number of lesions, calcium mass and density, no statistical difference was found between both imaging modalities. Agatston and Volumetric calcium score were statistically different between and within both scans. Mean variability of VCS of the two methods was calculated as 24% and was in the range of repeated EBT studies (14-44.9%). The Multi-Slice Spiral CT scanner is equivalent to EBT for the determination of coronary calcium and can, therefore, be used for calcium screening. Using a prospective ECG-trigger technique, the application of the Agatston method delivers statistically different results in comparison to EBT. With the application of the spiral mode technique, retrospective ECG-trigger and thinner slice thickness, further improvement in variability can be expected, thus allowing for follow-up studies to determine progression or regression of atherosclerosis with high accuracy.

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Recommendations for Standardization of EBT and MSCT Scanning

Abstract: The article summarizes guidelines for image acquisition and evaluation by EBT and describes guidelines and consensus reports that were issued concerning the clinical use of the method.

Cited by 12 publications

References 23 publications

Multidetector-row cardiac CT: diagnostic value of calcium scoring and CT coronary angiography in patients with symptomatic, but atypical, chest pain

Multidetector-row cardiac CT: diagnostic value of calcium scoring and CT coronary angiography in patients with symptomatic, but atypical, chest pain

Coronary calcium score: An Indian scenario and experience

Detektion von Koronarkalk mit der Mehrschicht-Spiral-Computertomographie: Eine Alternative zur Elektronenstrahltomographie

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