Top

Published in:

01-06-2016 | Chest

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

Authors: Antoine Hutt, Alain Duhamel, Valérie Deken, Jean-Baptiste Faivre, Francesco Molinari, Jacques Remy, Martine Remy-Jardin

Published in: European Radiology | Issue 6/2016

Abstract

Purpose

To investigate the reliability of ungated, high-pitch dual-source CT for coronary artery calcium (CAC) screening.

Materials and methods

One hundred and eighty-five smokers underwent a dual-source CT examination with acquisition of two sets of images during the same session: (a) ungated, high-pitch and high-temporal resolution acquisition over the entire thorax (i.e., chest CT); (b) prospectively ECG-triggered acquisition over the cardiac cavities (i.e., cardiac CT).

Results

Sensitivity and specificity of chest CT for detecting positive CAC scores were 96.4 % and 100 %, respectively. There was excellent inter-technique agreement for determining the quantitative CAC score (ICC = 0.986). The mean difference between the two techniques was 11.27, representing 1.81 % of the average of the two techniques. The inter-technique agreement for categorizing patients into the four ranks of severity was excellent (weighted kappa = 0.95; 95 % CI 0.93–0.98). The inter-technique differences for quantitative CAC scores did not correlate with BMI (r = 0.05, p = 0.575) or heart rate (r = –0.06, p = 0.95); 87.2 % of them were explained by differences at the level of the right coronary artery (RCA: 0.8718; LAD: 0.1008; LCx: 0.0139; LM: 0.0136).

Conclusion

Ungated, high-pitch dual-source CT is a reliable imaging mode for CAC screening in the conditions of routine chest CT examinations.

Key points

• CAC is an independent risk factor for major cardiac events.

• ECG-gated techniques are the reference standard for calcium scoring.

• Great interest is directed toward calcium scoring on non-gated chest CT examinations.

• Reliable calcium scoring can be obtained with dual-source CT in a high-pitch mode.

Shaw LJ, Raggi P, Schisterman E, Berman DS, Callister TQ (2003) Prognostic value of cardiac risk factors and coronary calcium screening for all-cause mortality. Radiology 228:826–833CrossRefPubMed

Shemesh J, Henschke CI, Farooqi A et al (2006) Frequency of coronary artery calcification on low-dose computed tomography screening for lung cancer. Clin Imaging 30:181–185CrossRefPubMed

Bastarrika G, Alonso A, Saiz-Mendiguren R, Arias J, Cosin O (2010) Coronary artery calcium quantification with non-ECG-gated low-dose CT of the chest. Radiologia 52:30–36CrossRefPubMed

Wu MT, Yang P, Huang YL et al (2008) Coronary arterial calcification on low-dose ungated MDCT for lung cancer screening: concordance study with dedicated cardiac CT. AJR Am J Roentgenol 190:923–928CrossRefPubMed

Budoff MJ, Nasir K, Kinney GL et al (2011) Coronary artery and thoracic calcium on noncontrast thoracic CT scans: comparison of ungated and gated examinations in patients from the COPD Gene cohort. J Cardiovasc Comput Tomogr 5:113–118CrossRefPubMedPubMedCentral

Tacelli N, Remy-Jardin M, Flohr T et al (2010) Dual-source chest CT angiography with high temporal resolution and high pitch modes: evaluation of image quality in 140 patients. Eur Radiol 20:1188–1196CrossRefPubMed

de Malherbe M, Duhamel A, Tacelli N et al (2012) Ultrafast imaging of the entire chest without ECG synchronization or beta-blockade : to what extent can we analyze the coronary arteries ? Insights Imaging 3:73–79CrossRefPubMedPubMedCentral

Tacelli N, Darchis C, Pontana F et al (2013) High-pitch, dual-source chest computed tomography angiography without electrocardiographic synchronization. Evaluation of cardiac motion artifacts on pulmonary circulation. J Thorac Imaging 28:376–382CrossRefPubMed

Baumueller S, Alkadhi A, Stolzmann P et al (2011) Computed tomography of the lung in the high-pitch mode: is breath holding still required? Invest Radiol 46:240–245CrossRefPubMed

10.

Schulz B, Jacobi V, Beeres M et al (2012) Quantitative analysis of motion artifacts in high-pitch dual-source computed tomography of the thorax. J Thorac Imaging 27:382–386CrossRefPubMed

11.

Bauer RW, Schell B, Beeres M et al (2012) High-pitch dual-source computed tomography pulmonary angiography in freely breathing patients. J Thorac Imaging 27:376–381CrossRefPubMed

12.

Agatston AS, Janowitz W, Hildner FJ, Zusmer NR, Viamonte M, Detrano R (1990) Quantification of coronary artery calcium using ultrafast CT. J Am Coll Cardiol 15:827–832CrossRefPubMed

13.

Huda W, Ogden KM, Khorasani MR (2008) Converting dose-length-product to effective dose at CT. Radiology 248:995–1003CrossRefPubMedPubMedCentral

14.

Xie X, Zhao Y, de Bock G et al (2013) Validation and prognosis of coronary artery calcium scoring in nontriggered thoracic computed tomography. Systematic review and meta-analysis. Circ Cardiovasc Imaging 6:514–521CrossRefPubMed

15.

Arcadi T, Maffei E, Sverzellati N et al (2014) Coronary artery calcium score on low-dose computed tomography for lung cancer screening. World J Radiol 6:381–387CrossRefPubMedPubMedCentral

16.

Greuter MJ, Groen JM, Nicolai LJ, Dijkstra H, Oudkerk M (2009) A model for quantitative correction of coronary calcium scores on multidetector, dual source, and electron beam computed tomography for influences of linear motion, calcification density and temporal resolution: a cardiac phantom study. Med Phys 36:5079–5088CrossRefPubMed

17.

Hofman MB, Wickline SA, Lorenz CH (1998) Quantification of in-plane motion of the coronary arteries during the cardiac cycle: implications for acquisition window duration for MR flow quantification. J Magn Reson Imaging 8:568–76CrossRefPubMed

18.

Divo M, Cote C, de Torres JP et al (2012) Comorbidities and risk of mortality in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 186:155–161CrossRefPubMed

19.

Mets OM, de Jong PA, Prokop M (2012) Computed tomographic screening for lung cancer: an opportunity to evaluate other diseases. JAMA 308:1433–1434CrossRefPubMed

20.

Nakazato R, Dey D, Gutstein A et al (2009) Coronary artery calcium scoring using a reduced tube voltage and radiation dose protocol with dual-source computed tomography. J Cardiovasc Comput Tomogr 3:394–400CrossRefPubMed

21.

Thomas CK, Mühlenbruch G, Wildberger JE et al (2006) Coronary artery calcium scoring with multislice computed tomography: in vitro assessment of a low tube voltage protocol. Invest Radiol 41:668–673CrossRefPubMed

22.

Murazaki H, Funama Y, Hatemura M, Fujioka C, Tomiguchi S (2011) Quantitative evaluation of calcium (content) in the coronary artery using hybrid iterative reconstruction (iDose) algorithm on low-dose 64-detector CT: comparison of iDose and filtered back projection. Nihon Hoshasen Gijutsu Gakkai Zasshi 67:360–366CrossRefPubMed

23.

Gebhard C, Fiechter M, Fuchs TA et al (2013) Coronary artery calcium scoring: Influence of adaptive statistical iterative reconstruction using 64-MDCT. Int J Cardiol 167:2932–2937CrossRefPubMed

24.

van Osch JA, Mouden M, van Dalen JA et al (2014) Influence of iterative image reconstruction on CT-based calcium score measurements. Int J Cardiovasc Imaging 30:961–967PubMed

25.

Matsuura N, Urashima M, Fukumoto W et al (2015) Radiation dose reduction at coronary artery calcium scoring by using a low tube current technique and hybrid iterative reconstruction. J Comput Asssit Tomogr 39:119–124CrossRef

Title: Coronary calcium screening with dual-source CT: reliability of ungated, high-pitch chest CT in comparison with dedicated calcium-scoring CT
Authors: Antoine Hutt
Alain Duhamel
Valérie Deken
Jean-Baptiste Faivre
Francesco Molinari
Jacques Remy
Martine Remy-Jardin
Publication date: 01-06-2016
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 6/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-3978-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Purpose

Materials and methods

Results

Conclusion

Key points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusion

Key points

Please log in to get access to this content

Other articles of this Issue 6/2016

Tomosynthesis-guided vacuum-assisted breast biopsy: A feasibility study

Subchondral insufficiency fractures of the femoral head: associated imaging findings and predictors of clinical progression

Late gadolinium enhancement cardiac imaging on a 3T scanner with parallel RF transmission technique: prospective comparison of 3D-PSIR and 3D-IR

Persistent pulmonary subsolid nodules with solid portions of 5 mm or smaller: Their natural course and predictors of interval growth

Intravoxel incoherent motion magnetic resonance imaging to predict vesicoureteral reflux in children with urinary tract infection

Biliary intraductal metastasis from advanced gastric cancer: radiologic and histologic characteristics, and clinical outcomes of percutaneous metallic stent placement