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Coronary artery calcium quantification at multi-detector row CT: influence of heart rate and measurement methods on
Cheng Hong1, Kyongtae T Bae, Thomas K Pilgram
1Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, CB 8131, St Louis, MO 63110, USA.
Insights
Lowering heart rate during multi-detector row CT improves coronary calcium measurement consistency. Coronary calcium mass measurement is more reproducible than score or volume methods, especially at heart rates below 70 bpm.
Area of Science:
- Cardiovascular imaging
- Radiology
- Medical diagnostics
Background:
- Coronary artery calcification (CAC) is a key indicator of cardiovascular disease risk.
- Accurate quantification of CAC is crucial for risk stratification.
- Multi-detector row computed tomography (CT) is widely used for CAC assessment.
Purpose of the Study:
- To evaluate the impact of heart rate on the consistency of different coronary calcium quantification techniques using multi-detector row CT.
- To determine which CAC quantification method exhibits the least variability at varying heart rates.
Main Methods:
- Fifty adult participants with diverse heart rates underwent two consecutive, prospectively ECG-triggered multi-detector row CT scans.
- Coronary calcium score, volume, and mass were measured for each acquisition.
- Interacquisition variability was analyzed in relation to heart rate and quantification method.
Main Results:
- Coronary calcium mass measurement demonstrated significantly lower interacquisition variability (10.4%) compared to score (23.9%) and volume (15.7%) measurements.
- Interacquisition variability for all methods increased significantly at heart rates above 70 beats per minute (bpm).
- Variability differed by coronary vessel, with left main and left anterior descending arteries showing higher correlation with heart rate.
Conclusions:
- Lowering heart rate significantly reduces interacquisition variability in coronary calcium measurements obtained via multi-detector row CT.
- Coronary calcium mass quantification offers superior reproducibility compared to score and volume methods.
- Heart rate is a critical factor influencing the reliability of CAC quantification.
Purpose:
To assess the effect of heart rate on interacquisition variability in different coronary calcium quantification methods at multi-detector row computed tomography (CT).
Materials And Methods:
Fifty consecutive adults (39 men and 11 women; mean age, 57 years +/- 13 [SD]) with various heart rates were examined with two prospectively electrocardiographically triggered multi-detector row CT acquisitions in succession for detection and quantification of coronary artery calcification. Calcium score, volume, and mass were measured for each acquisition. Interacquisition variability was evaluated in association with heart rate and quantification method in subjects and individual coronary vessels by using t tests and analysis of variance.
Results:
In 37 subjects with detected calcium, interacquisition variability in mass measurement (10.4%) was significantly lower than that in score (23.9%) and volume (15.7%) measurements (P <.02). The interacquisition variability in all quantification methods was well correlated with heart rate and was considerably greater when heart rates were higher than 70 beats per minute (bpm) than when heart rates were 70 bpm or lower (P <.002). There was a clear tendency for interacquisition variability to vary by vessel (P <.01). The correlation of interacquisition variability with heart rate and a significant difference in interacquisition variability between the group with heart rates of 70 bpm or lower and the group with rates higher than 70 bpm (P <.02) were found for the left main and left anterior descending arteries but not for the circumflex and right coronary arteries.
Conclusion:
Interacquisition variability in coronary calcium measurements at multi-detector row CT is significantly less at lower heart rates. The coronary calcium mass measurement is more reproducible than are score and volume measurements.