Published in:
Open Access 01-12-2018 | Original Article
Automatic determination of cardiovascular risk by CT attenuation correction maps in Rb-82 PET/CT
Published in: Journal of Nuclear Cardiology | Issue 6/2018
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Background
We investigated fully automatic coronary artery calcium (CAC) scoring and cardiovascular disease (CVD) risk categorization from CT attenuation correction (CTAC) acquired at rest and stress during cardiac PET/CT and compared it with manual annotations in CTAC and with dedicated calcium scoring CT (CSCT).
Methods and Results
We included 133 consecutive patients undergoing myocardial perfusion 82Rb PET/CT with the acquisition of low-dose CTAC at rest and stress. Additionally, a dedicated CSCT was performed for all patients. Manual CAC annotations in CTAC and CSCT provided the reference standard. In CTAC, CAC was scored automatically using a previously developed machine learning algorithm. Patients were assigned to a CVD risk category based on their Agatston score (0, 1-10, 11-100, 101-400, >400). Agreement in CVD risk categorization between manual and automatic scoring in CTAC at rest and stress resulted in Cohen’s linearly weighted κ of 0.85 and 0.89, respectively. The agreement between CSCT and CTAC at rest resulted in κ of 0.82 and 0.74, using manual and automatic scoring, respectively. For CTAC at stress, these were 0.79 and 0.70, respectively.
Conclusion
Automatic CAC scoring from CTAC PET/CT may allow routine CVD risk assessment from the CTAC component of PET/CT without any additional radiation dose or scan time.