Variation of the coronary calcium score depending on image reconstruction interval and scoring algorithm

Area of Science:

• Radiology
• Cardiovascular Imaging
• Medical Physics

Background:

• Coronary calcium scoring is crucial for cardiovascular risk assessment.
• Image reconstruction parameters can influence coronary calcium score (CCS) accuracy.
• Understanding reconstruction interval dependency is vital for standardized CCS quantification.

Purpose of the Study:

• To evaluate the impact of reconstruction interval on coronary calcium score (CCS) using different image reconstruction and quantification methods.
• To assess the intraobserver variability of CCS across various reconstruction intervals.
• To identify optimal parameters for reliable CCS measurement.

Main Methods:

• Seventy-five patients underwent retrospectively ECG-gated multislice spiral CT for coronary calcium scoring.
• Overlapping and non-overlapping image reconstructions were performed every 10% of the RR-interval.
• Coronary calcium scores were calculated using Agatston and volumetric methods, with intraobserver variability assessed in 25 patients.

Main Results:

• Coronary calcium scores varied significantly with reconstruction intervals, ranging from 91.6 to 216.2 depending on the method.
• Variation in CCS ranged from 17.5% (volumetric, overlapping) to 45.5% (Agatston, non-overlapping).
• Least intraobserver variability (0.78%–21.51%) was observed with volumetric scoring and overlapping reconstruction during diastole.

Conclusions:

• Diastolic image reconstruction at 50% or 60% of the RR-interval is recommended for retrospectively ECG-gated multislice spiral CT.
• Volumetric calcium scoring combined with overlapping image reconstruction effectively reduces CCS variation.
• These optimized parameters enhance the reliability and consistency of coronary calcium scoring.