Relative predictive value of lung cancer screening CT versus myocardial perfusion attenuation correction CT in the evaluation of coronary calcium

Bailey, Grant; Healy, Abigail; Young, Bryan D.; Sharma, Esseim; Meadows, Judith; Chun, Hyung J.; Wu, Wen‐Chih; Choudhary, Gaurav; Morrison, Alan

doi:10.1371/journal.pone.0175678

Cited by 6 publications

(6 citation statements)

References 40 publications

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“…The results of the study demonstrated that an automatic CCS scoring from AC combined with a fast-visual quality control of the calcific region may allow routine CAD risk assessment. The same threshold was applied by Bailey et al ( 2017 ). They identified 40 patients in an elevated risk population who underwent lung cancer screening computed tomography (non-gated) (LCS-CT), CCS, and AC-CT within the same 2-year period.…”

Section: Introductionmentioning

confidence: 99%

“…Larger slices thickness than the standard (3 mm) lead to significantly reduced scoring results with the opposite found using thinner slices (Christensen et al 2019 ) where soft kernels are recommended in CCS (Sprem et al 2018 ). Looking at the outperformance of the LCS-CT in the study by Bailey et al ( 2017 ), despite the intrinsic limitation, so long as appropriate an acquisition has been made it can be reasonable having two reconstructions from a single AC-CCS study, one for the AC, using 5 mm thickness and the full SFOV, and one for CCS, using a 2.5–3 mm slice thickness and a maximum DFOV of 400 mm, as used for LCS-CT.…”

Section: Introductionmentioning

confidence: 99%

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Best practice for the nuclear medicine technologist in CT-based attenuation correction and calcium score for nuclear cardiology

Camoni

Santos

Attard

et al. 2020

European J Hybrid Imaging

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The use of hybrid systems is increasingly growing in Europe and this is progressively important for the final result of diagnostic tests. As an integral part of the hybrid imaging system, computed tomography (CT) plays a crucial role in myocardial perfusion imaging diagnostics. Throughout Europe, a variety of equipment is available and also different university curricula of the nuclear medicine technologist are observed. Hence, the Technologist Committee of the European Association of Nuclear Medicine proposes to identify, through a bibliographic review, the recommendations for best practice in computed tomography applied to attenuation correction and calcium score in myocardial perfusion imaging, which courses in the set of knowledge, skills, and competencies for nuclear medicine technologists. This document aims at providing recommendations for CT acquisition protocols and CT image optimization in nuclear cardiology.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Best practice for the nuclear medicine technologist in CT-based attenuation correction and calcium score for nuclear cardiology

Camoni

Santos

Attard

et al. 2020

European J Hybrid Imaging

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“…From the literature search, a total of 4000 patients from 16 studies were included in this meta-analysis [ 12 13 14 16 17 18 19 20 21 28 29 30 31 32 33 34 ]. Table 1 summarizes the study characteristics, CAC scoring method, and technical considerations for the non-ECG-gated CT scans.…”

Section: Resultsmentioning

confidence: 99%

“…The same slice thickness (2.5 or 3 mm) was used for non-ECG-gated CT in 9 studies [ 12 13 14 19 29 30 31 32 34 ]. Different slice thicknesses were used in 8 studies: thinner slices (≤ 2 mm) in 3 studies [ 12 17 28 ] and thicker slices (5 mm) in 5 studies [ 12 14 16 21 33 ]. The studies that used the same slice thickness had higher correlation coefficients and weighted kappa than studies that used different slice thicknesses.…”

Section: Resultsmentioning

confidence: 99%

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Reliability of Coronary Artery Calcium Severity Assessment on Non-Electrocardiogram-Gated CT: A Meta-Analysis

et al. 2021

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Objective The purpose of this meta-analysis was to investigate the pooled agreements of the coronary artery calcium (CAC) severities assessed by electrocardiogram (ECG)-gated and non-ECG-gated CT and evaluate the impact of the scan parameters. Materials and Methods PubMed, EMBASE, and the Cochrane library were systematically searched. A modified Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to evaluate the quality of the studies. Meta-analytic methods were utilized to determine the pooled weighted bias, limits of agreement (LOA), and the correlation coefficient of the CAC scores or the weighted kappa for the categorization of the CAC severities detected by the two modalities. The heterogeneity among the studies was also assessed. Subgroup analyses were performed based on factors that could affect the measurement of the CAC score and severity: slice thickness, reconstruction kernel, and radiation dose for non-ECG-gated CT. Results A total of 4000 patients from 16 studies were included. The pooled bias was 62.60, 95% LOA were −36.19 to 161.40, and the pooled correlation coefficient was 0.94 (95% confidence interval [CI] = 0.89–0.97) for the CAC score. The pooled weighted kappa of the CAC severity was 0.85 (95% CI = 0.79–0.91). Heterogeneity was observed in the studies (I 2 > 50%, p < 0.1). In the subgroup analysis, the agreement between the CAC categorizations was better when the two CT examinations had reconstructions based on the same slice thickness and kernel. Conclusion The pooled agreement of the CAC severities assessed by the ECG-gated and non-ECG-gated CT was excellent; however, it was significantly affected by scan parameters, such as slice thickness and the reconstruction kernel.

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Prevalence and clinical implications of coronary artery calcium scoring on non-gated thoracic computed tomography: a systematic review and meta-analysis

Osborne-Grinter,

Ali,

Williams

2023

Eur Radiol

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Objectives Coronary artery calcifications (CACs) indicate the presence of coronary artery disease. CAC can be found on thoracic computed tomography (CT) conducted for non-cardiac reasons. This systematic review and meta-analysis of non-gated thoracic CT aims to assess the clinical impact and prevalence of CAC. Methods Online databases were searched for articles assessing prevalence, demographic characteristics, accuracy and prognosis of incidental CAC on non-gated thoracic CT. Meta-analysis was performed using a random effects model. Results A total of 108 studies (113,406 patients) were included (38% female). Prevalence of CAC ranged from 2.7 to 100% (pooled prevalence 52%, 95% confidence interval [CI] 46–58%). Patients with CAC were older (pooled standardised mean difference 0.88, 95% CI 0.65–1.11, p < 0.001), and more likely to be male (pooled odds ratio [OR] 1.95, 95% CI 1.55–2.45, p < 0.001), with diabetes (pooled OR 2.63, 95% CI 1.95–3.54, p < 0.001), hypercholesterolaemia (pooled OR 2.28, 95% CI 1.33–3.93, p < 0.01) and hypertension (pooled OR 3.89, 95% CI 2.26–6.70, p < 0.001), but not higher body mass index or smoking. Non-gated CT assessment of CAC had excellent agreement with electrocardiogram-gated CT (pooled correlation coefficient 0.96, 95% CI 0.92–0.98, p < 0.001). In 51,582 patients, followed-up for 51.6 ± 27.4 months, patients with CAC had increased all cause mortality (pooled relative risk [RR] 2.13, 95% CI 1.57–2.90, p = 0.004) and major adverse cardiovascular events (pooled RR 2.91, 95% CI 2.26–3.93, p < 0.001). When CAC was present on CT, it was reported in between 18.6% and 93% of reports. Conclusion CAC is a common, but underreported, finding on non-gated CT with important prognostic implications. Clinical relevance statement Coronary artery calcium is an important prognostic indicator of cardiovascular disease. It can be assessed on non-gated thoracic CT and is a commonly underreported finding. This represents a significant population where there is a potential missed opportunity for lifestyle modification recommendations and preventative therapies. This study aims to highlight the importance of reporting incidental coronary artery calcium on non-gated thoracic CT. Key Points • Coronary artery calcification is a common finding on non-gated thoracic CT and can be reliably identified compared to gated-CT. • Coronary artery calcification on thoracic CT is associated with an increased risk of all cause mortality and major adverse cardiovascsular events. • Coronary artery calcification is frequently not reported on non-gated thoracic CT.

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Relative predictive value of lung cancer screening CT versus myocardial perfusion attenuation correction CT in the evaluation of coronary calcium

Cited by 6 publications

References 40 publications

Best practice for the nuclear medicine technologist in CT-based attenuation correction and calcium score for nuclear cardiology

Best practice for the nuclear medicine technologist in CT-based attenuation correction and calcium score for nuclear cardiology

Reliability of Coronary Artery Calcium Severity Assessment on Non-Electrocardiogram-Gated CT: A Meta-Analysis

Prevalence and clinical implications of coronary artery calcium scoring on non-gated thoracic computed tomography: a systematic review and meta-analysis

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