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Coronary artery calcium quantification at multi-detector row helical CT versus electron-beam CT
William Stanford1, Brad H Thompson, Trudy L Burns
1Department of Radiology, College of Medicine, University of Iowa, 200 Hawkins Dr, Iowa City, IA 52242, USA. william-stanford@uiowa.edu
Radiology
|January 31, 2004
Summary
Multi-detector row CT is comparable to electron-beam CT for coronary artery calcium screening. However, scores may differ significantly in subjects with very low calcium scores (less than 11).
Area of Science:
- Cardiovascular imaging
- Radiology
- Medical diagnostics
Background:
- Coronary artery calcium (CAC) scoring is crucial for cardiovascular risk assessment.
- Electron-beam computed tomography (EBCT) has been a standard for CAC scoring.
- Advancements in multi-detector row helical computed tomography (MDCT) necessitate comparison with established methods.
Purpose of the Study:
- To compare CAC scores obtained from MDCT and EBCT scanners.
- To evaluate the agreement between the two CT modalities, particularly for subjects with low calcium scores (<400).
Main Methods:
- Seventy-eight asymptomatic subjects underwent both MDCT and EBCT scans.
- Volume and Agatston CAC scores were calculated and statistically analyzed.
- Analyses included association, percent absolute difference, equivalence testing, and Bland-Altman plots.
Main Results:
- EBCT scores were generally higher than MDCT scores.
- Strong linear association (r = 0.96-0.99) was observed between scanners.
- For scores ≥11, mean differences were 15%-30%, but statistically equivalent within a 20% limit.
- Score grouping and risk management decisions could change in a subset of patients.
Conclusions:
- MDCT is comparable to EBCT for CAC screening.
- MDCT may be less reliable for subjects with very low calcium scores (<11).
- Clinical decisions based on CAC scores require careful consideration of the scoring modality.