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Published in: The International Journal of Cardiovascular Imaging 2/2017

01-02-2017 | Original Paper

National trends among radiologists in reporting coronary artery calcium in non-gated chest computed tomography

Authors: Jacobo Kirsch, Felipe Martinez, David Lopez, Gian M. Novaro, Craig R. Asher

Published in: The International Journal of Cardiovascular Imaging | Issue 2/2017

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Abstract

Coronary artery calcification (CAC) is a known risk factor for adverse outcomes in the general population and in patients with coronary artery disease. We performed a survey of United States radiologists to evaluate the trends in reporting the presence or absence of CAC on NCCT examinations. An 11 multiple-choice questionnaire was distributed to members of the American College of Radiology, and 530 members participated in the study. Eighty-seven percent of the analyzed group report the presence of CAC on standard CT scans of the chest, and approximately half them (52 %) use a qualitative modifier. Only 32 % of cardiac imagers were aware of the published data correlating qualitative and quantitative calcium scores on non-gated chest CT examinations compared to 17 % of non-cardiac imagers. We believe that subjective or objective grading of coronary calcified plaque burden on standard chest CT exams is warranted as it may not only help risk-stratify patients, but also may eliminate the need for dedicated CACS in many patients and may be useful in treatment guidance.
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Literature
1.
3.
go back to reference Tanenbaum SR, Kondos GT, Veselik KE et al (1989) Detection of calcific deposits in coronary arteries by ultrafast computed tomography and correlation with angiography. Am J Cardiol 63:870–872CrossRefPubMed Tanenbaum SR, Kondos GT, Veselik KE et al (1989) Detection of calcific deposits in coronary arteries by ultrafast computed tomography and correlation with angiography. Am J Cardiol 63:870–872CrossRefPubMed
4.
go back to reference Hecht HS (2015) Coronary artery calcium scanning: past, present, and future. JACC Cardiovasc Imaging 8(5):579–596CrossRefPubMed Hecht HS (2015) Coronary artery calcium scanning: past, present, and future. JACC Cardiovasc Imaging 8(5):579–596CrossRefPubMed
5.
go back to reference Greenland P, Alpert JS, Beller GA et al (2010) ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 56:e50–e103CrossRefPubMed Greenland P, Alpert JS, Beller GA et al (2010) ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 56:e50–e103CrossRefPubMed
6.
go back to reference Williams KA, Kim JT, Holohan KM (2013) Frequency of unrecognized, unreported, or underreported coronary artery and cardiovascular calcification on noncardiac chest CT. J Cardiovasc Comput Tomogr 7(3):167–172CrossRefPubMed Williams KA, Kim JT, Holohan KM (2013) Frequency of unrecognized, unreported, or underreported coronary artery and cardiovascular calcification on noncardiac chest CT. J Cardiovasc Comput Tomogr 7(3):167–172CrossRefPubMed
7.
go back to reference Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, de Ferranti S, Després JP, Fullerton HJ, Howard VJ, Huffman MD, Judd SE, Kissela BM, Lackland DT, Lichtman JH, Lisabeth LD, Liu S, Mackey RH, Matchar DB, McGuire DK, Mohler ER 3rd, Moy CS, Muntner P, Mussolino ME, Nasir K, Neumar RW, Nichol G, Palaniappan L, Pandey DK, Reeves MJ, Rodriguez CJ, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Willey JZ, Woo D, Yeh RW, Turner MB American Heart Association Statistics Committee and Stroke Statistics Subcommittee (2015) Heart disease and stroke statistics–2015 update: a report from the American Heart Association. Circulation 131(4):e29–e322CrossRefPubMed Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, de Ferranti S, Després JP, Fullerton HJ, Howard VJ, Huffman MD, Judd SE, Kissela BM, Lackland DT, Lichtman JH, Lisabeth LD, Liu S, Mackey RH, Matchar DB, McGuire DK, Mohler ER 3rd, Moy CS, Muntner P, Mussolino ME, Nasir K, Neumar RW, Nichol G, Palaniappan L, Pandey DK, Reeves MJ, Rodriguez CJ, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Willey JZ, Woo D, Yeh RW, Turner MB American Heart Association Statistics Committee and Stroke Statistics Subcommittee (2015) Heart disease and stroke statistics–2015 update: a report from the American Heart Association. Circulation 131(4):e29–e322CrossRefPubMed
8.
go back to reference Eggen DA, Strong JP, McGill HC Jr (1965) Coronary calcification. Relationship to clinically significant coronary lesions and race, sex, and topographic distribution. Circulation 32(6):948–955CrossRefPubMed Eggen DA, Strong JP, McGill HC Jr (1965) Coronary calcification. Relationship to clinically significant coronary lesions and race, sex, and topographic distribution. Circulation 32(6):948–955CrossRefPubMed
9.
10.
go back to reference Bartel AG, Chen JT, Peter RH, Behar VS, Kong Y, Lester RG (1974) The significance of coronary calcification detected by fluoroscopy. A report of 360 patients. Circulation 49(6):1247–1253CrossRefPubMed Bartel AG, Chen JT, Peter RH, Behar VS, Kong Y, Lester RG (1974) The significance of coronary calcification detected by fluoroscopy. A report of 360 patients. Circulation 49(6):1247–1253CrossRefPubMed
11.
go back to reference Margolis JR, Chen JT, Kong Y, Peter RH, Behar VS, Kisslo JA (1980) The diagnostic and prognostic significance of coronary artery calcification. A report of 800 cases. Radiology 137(3):609–616CrossRefPubMed Margolis JR, Chen JT, Kong Y, Peter RH, Behar VS, Kisslo JA (1980) The diagnostic and prognostic significance of coronary artery calcification. A report of 800 cases. Radiology 137(3):609–616CrossRefPubMed
12.
go back to reference Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M Jr, Detrano R (1990) Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 15(4):827–832CrossRefPubMed Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M Jr, Detrano R (1990) Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 15(4):827–832CrossRefPubMed
13.
go back to reference Janowitz WR, Agatston AS, Kaplan G, Viamonte M Jr (1993) Differences in prevalence and extent of coronary artery calcium detected by ultrafast computed tomography in asymptomatic men and women. Am J Cardiol 72(3):247–254CrossRefPubMed Janowitz WR, Agatston AS, Kaplan G, Viamonte M Jr (1993) Differences in prevalence and extent of coronary artery calcium detected by ultrafast computed tomography in asymptomatic men and women. Am J Cardiol 72(3):247–254CrossRefPubMed
16.
go back to reference Wu M-T, Yang P, Huang Y-L, Chen J-S, Chuo C-C, Yeh C, Chang R-S (2008) Coronary arterial calcification on low-dose ungated mdct for lung cancer screening: concordance study with dedicated cardiac CT. Am J Roentgenol 190(4):923–928. doi:10.2214/AJR.07.2974 CrossRef Wu M-T, Yang P, Huang Y-L, Chen J-S, Chuo C-C, Yeh C, Chang R-S (2008) Coronary arterial calcification on low-dose ungated mdct for lung cancer screening: concordance study with dedicated cardiac CT. Am J Roentgenol 190(4):923–928. doi:10.​2214/​AJR.​07.​2974 CrossRef
17.
go back to reference Kirsch J, Buitrago I, Mohammed, T-LH., Gao T, Asher CR, Novaro GM (2011) Detection of coronary calcium during standard chest computed tomography correlates with multi-detector computed tomography coronary artery calcium score. Int J Cardiovasc Imaging 28(5):1249–1256. doi:10.1007/s10554-011-9928-9 CrossRefPubMed Kirsch J, Buitrago I, Mohammed, T-LH., Gao T, Asher CR, Novaro GM (2011) Detection of coronary calcium during standard chest computed tomography correlates with multi-detector computed tomography coronary artery calcium score. Int J Cardiovasc Imaging 28(5):1249–1256. doi:10.​1007/​s10554-011-9928-9 CrossRefPubMed
18.
go back to reference Hughes-Austin JM, Dominguez A 3rd, Allison MA, Wassel CL, Rifkin DE, Morgan CG, Daniels MR, Ikram U, Knox JB, Wright CM, Criqui MH, Ix JH (2016) Relationship of coronary calcium on standard chest CT scans with mortality. JACC 9(2):152–159PubMedPubMedCentral Hughes-Austin JM, Dominguez A 3rd, Allison MA, Wassel CL, Rifkin DE, Morgan CG, Daniels MR, Ikram U, Knox JB, Wright CM, Criqui MH, Ix JH (2016) Relationship of coronary calcium on standard chest CT scans with mortality. JACC 9(2):152–159PubMedPubMedCentral
19.
go back to reference Sandfort V, Ahlman MA, Jones EC, Selwaness M, Chen MY, Folio LR (2016) Bluemke DA2. High pitch third generation dual-source CT: coronary and cardiac visualization on routine chest CT. J Cardiovasc Comput Tomogr 10(4):282–288CrossRefPubMed Sandfort V, Ahlman MA, Jones EC, Selwaness M, Chen MY, Folio LR (2016) Bluemke DA2. High pitch third generation dual-source CT: coronary and cardiac visualization on routine chest CT. J Cardiovasc Comput Tomogr 10(4):282–288CrossRefPubMed
20.
go back to reference Jacobs PCA, Isgum I, Gondrie MJA, Mali WPTM, van Ginneken B, Prokop M, van der Graaf Y (2010) Coronary artery calcification scoring in low-dose ungated ct screening for lung cancer: interscan agreement. Am J Roentgenol 194(5):1244–1249. doi:10.2214/AJR.09.3047 CrossRef Jacobs PCA, Isgum I, Gondrie MJA, Mali WPTM, van Ginneken B, Prokop M, van der Graaf Y (2010) Coronary artery calcification scoring in low-dose ungated ct screening for lung cancer: interscan agreement. Am J Roentgenol 194(5):1244–1249. doi:10.​2214/​AJR.​09.​3047 CrossRef
21.
go back to reference Shemesh J, Henschke CI, Shaham D, Yip R, Farooqi AO, Cham MD et al (2010) Ordinal scoring of coronary artery calcifications on low-dose CT scans of the chest is predictive of death from cardiovascular disease 1. Radiology 257(2):541–548. doi:10.1148/radiol.10100383 CrossRefPubMed Shemesh J, Henschke CI, Shaham D, Yip R, Farooqi AO, Cham MD et al (2010) Ordinal scoring of coronary artery calcifications on low-dose CT scans of the chest is predictive of death from cardiovascular disease 1. Radiology 257(2):541–548. doi:10.​1148/​radiol.​10100383 CrossRefPubMed
22.
go back to reference Takx RA, Išgum I, Willemink MJ, van der Graaf Y, de Koning HJ, Vliegenthart R, Oudkerk M, Leiner T, de Jong PA (2015) Quantification of coronary artery calcium in nongated CT to predict cardiovascular events in male lung cancer screening participants: Results of the NELSON study. J Cardiovasc Comput Tomogr 9(1):50–57CrossRefPubMed Takx RA, Išgum I, Willemink MJ, van der Graaf Y, de Koning HJ, Vliegenthart R, Oudkerk M, Leiner T, de Jong PA (2015) Quantification of coronary artery calcium in nongated CT to predict cardiovascular events in male lung cancer screening participants: Results of the NELSON study. J Cardiovasc Comput Tomogr 9(1):50–57CrossRefPubMed
23.
go back to reference Uretsky S, Chokshi N, Kobrinski T, Agarwal SK, Po JR, Awan H et al (2015) The interplay of physician awareness and reporting of incidentally found coronary artery calcium on the clinical management of patients who underwent noncontrast chest computed tomography. Am J Cardiol 115(11):1513–1517. doi:10.1016/j.amjcard.2015.02.051 CrossRefPubMed Uretsky S, Chokshi N, Kobrinski T, Agarwal SK, Po JR, Awan H et al (2015) The interplay of physician awareness and reporting of incidentally found coronary artery calcium on the clinical management of patients who underwent noncontrast chest computed tomography. Am J Cardiol 115(11):1513–1517. doi:10.​1016/​j.​amjcard.​2015.​02.​051 CrossRefPubMed
24.
go back to reference Kalia NK, Miller LG, Nasir K et al (2006) Visualizing coronary calcium is associated with improvements in adherence to statin therapy. Atherosclerosis 185:394–399CrossRefPubMed Kalia NK, Miller LG, Nasir K et al (2006) Visualizing coronary calcium is associated with improvements in adherence to statin therapy. Atherosclerosis 185:394–399CrossRefPubMed
25.
go back to reference Orakzai RH, Nasir K, Orakzai SH et al (2008) Effect of patient visualization of coronary calcium by electron beam computed tomography on changes in beneficial lifestyle behaviors. Am J Cardiol 101:999–1002CrossRefPubMed Orakzai RH, Nasir K, Orakzai SH et al (2008) Effect of patient visualization of coronary calcium by electron beam computed tomography on changes in beneficial lifestyle behaviors. Am J Cardiol 101:999–1002CrossRefPubMed
26.
go back to reference Taylor AJ, Bindeman J, Feuerstein I et al (2008) Community-based provision of statin and aspirin after the detection of coronary artery calcium within a community-based screening cohort. J Am Coll Cardiol 51:1337–1341CrossRefPubMed Taylor AJ, Bindeman J, Feuerstein I et al (2008) Community-based provision of statin and aspirin after the detection of coronary artery calcium within a community-based screening cohort. J Am Coll Cardiol 51:1337–1341CrossRefPubMed
27.
go back to reference Kavousi M, Elias-Smale S, Rutten JH, Leening MJ, Vliegenthart R, Ver-woert GC, Krestin GP, Oudkerk M, de Maat MP, Leebeek FW, Mattace-Raso FU, Lindemans J, Hofman A, Steyerberg EW, van der Lugt A, van den Meiracker AH, Witteman JC (2012) Evaluation of newer risk markers for coronary heart disease risk classi cation: a cohort study. Ann Intern Med 156:438–444CrossRefPubMed Kavousi M, Elias-Smale S, Rutten JH, Leening MJ, Vliegenthart R, Ver-woert GC, Krestin GP, Oudkerk M, de Maat MP, Leebeek FW, Mattace-Raso FU, Lindemans J, Hofman A, Steyerberg EW, van der Lugt A, van den Meiracker AH, Witteman JC (2012) Evaluation of newer risk markers for coronary heart disease risk classi cation: a cohort study. Ann Intern Med 156:438–444CrossRefPubMed
28.
go back to reference Miedema MD, Duprez DA, Misialek JR, Blaha MJ, Nasir K, Silverman MG, Blankstein R, Budoff MJ, Greenland P, Folsom AR (2014) Use of coronary artery calcium testing to guide aspirin utilization for primary prevention: estimates from the multi-ethnic study of atherosclerosis. Circ Cardiovasc Qual Outcomes 7:453–460CrossRefPubMedPubMedCentral Miedema MD, Duprez DA, Misialek JR, Blaha MJ, Nasir K, Silverman MG, Blankstein R, Budoff MJ, Greenland P, Folsom AR (2014) Use of coronary artery calcium testing to guide aspirin utilization for primary prevention: estimates from the multi-ethnic study of atherosclerosis. Circ Cardiovasc Qual Outcomes 7:453–460CrossRefPubMedPubMedCentral
29.
go back to reference VanGeest JB, Johnson TP, Welch VL (2007) Methodologies for improving response rates in surveys of physicians: a systematic review. Eval Health Prof 30(4):303–321CrossRefPubMed VanGeest JB, Johnson TP, Welch VL (2007) Methodologies for improving response rates in surveys of physicians: a systematic review. Eval Health Prof 30(4):303–321CrossRefPubMed
Metadata
Title
National trends among radiologists in reporting coronary artery calcium in non-gated chest computed tomography
Authors
Jacobo Kirsch
Felipe Martinez
David Lopez
Gian M. Novaro
Craig R. Asher
Publication date
01-02-2017
Publisher
Springer Netherlands
Published in
The International Journal of Cardiovascular Imaging / Issue 2/2017
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-016-0986-x

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