Related Experiment Video
Updated: Jul 3, 2026
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Accurate determination of high-risk coronary lesion type by multidetector cardiac computed tomography
Mirvat Alasnag1, Branavan Umakanthan, Gary P Foster
1Veterans Affairs Loma Linda Healthcare System, Loma Linda University School of Medicine, Loma Linda, California, USA. mirvatalasnag@yahoo.com
Insights
Multidetector cardiac computerized tomography (MDCT) accurately categorizes high-risk coronary lesions, offering a noninvasive alternative to coronary arteriography (CA) for intervention planning. This advanced imaging technique shows strong concordance for complex lesion types.
Area of Science:
- Cardiovascular Imaging
- Medical Diagnostics
- Interventional Cardiology
Background:
- Coronary arteriography (CA) is the gold standard for imaging coronary lesions.
- Multidetector cardiac computerized tomography (MDCT) offers high-resolution, noninvasive imaging of coronary arteries.
- The ability of MDCT to categorize coronary lesion types has not been previously assessed.
Purpose of the Study:
- To evaluate the accuracy of MDCT in categorizing coronary lesion types.
- To compare MDCT lesion categorization against coronary arteriography (CA) as the reference standard.
Main Methods:
- Patients undergoing both MDCT and CA within two months were included.
- MDCT and CA images were reviewed blindly and lesions classified using the SCAI system (Types I-IV).
- Spearman Correlation Test was used to analyze data from major coronary artery segments.
Main Results:
- A total of 411 segments were analyzed, with 110 lesions identified across various coronary arteries.
- Significant correlations (p < 0.001) were found between MDCT and CA for all major vessels.
- Concordance was high for lesion Types II-IV (97%) but poor for Type I (30%).
Conclusions:
- MDCT can accurately categorize high-risk coronary lesion types.
- MDCT demonstrates potential as a crucial noninvasive tool for planning coronary interventions.
Background:
Coronary arteriography (CA) is the standard method to image coronary lesions. Multidetector cardiac computerized tomography (MDCT) provides high-resolution images of coronary arteries, allowing a noninvasive alternative to determine lesion type. To date, no studies have assessed the ability of MDCT to categorize coronary lesion types.
Hypothesis:
The objective of this study was to determine the accuracy of lesion type categorization by MDCT using CA as a reference standard.
Methods:
Patients who underwent both MDCT and CA within 2 months of each other were enrolled. MDCT and CA images were reviewed in a blinded fashion. Lesions were categorized according to the SCAI classification system (Types I-IV). The origin, proximal and middle segments of the major arteries were analyzed. Each segment comprised a data point for comparison. Analysis was performed using the Spearman Correlation Test.
Results:
Four hundred eleven segments were studied, of which 110 had lesions. The lesion distribution was as follows: 35 left anterior descending (LAD), 29 circumflex (Cx), 31 right coronary artery (RCA), 2 ramus intermedius, 8 diagonal, 4 obtuse marginal and 2 left internal mammary arteries. Correlations between MDCT and CA were significant in all major vessels (LAD, Cx, RCA) (p < 0.001). The overall correlation coefficient was 0.67. Concordance was strong for lesion Types II-IV (97%) and poor for Type I (30%).
Conclusion:
High-risk coronary lesion types can be accurately categorized by MDCT. This ability may allow MDCT to play an important noninvasive role in the planning of coronary interventions.
Related Concept Videos
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:28Imaging Studies for Cardiovascular System V: CT
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
01:10Computed Tomography
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...