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Semi-Automatic Graphical Tool for Measuring Coronary Artery Spatially Weighted Calcium Score from Gated Cardiac Computed Tomography Images
Published on: September 22, 2023
Measuring coronary artery calcification using positron emission tomography-computed tomography attenuation correction
Ilias Mylonas1, Mustapha Kazmi, Lyanne Fuller
1Department of Medicine Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, Canada K1Y 4W7.
European Heart Journal. Cardiovascular Imaging
|April 19, 2012
Summary
Quantifying coronary artery calcium (CAC) using cardiac positron emission tomography (PET) attenuation correction (CT) images is feasible and accurate. This method allows for CAC assessment during a single PET scan without additional radiation exposure.
Area of Science:
- Cardiovascular imaging
- Radiology
- Nuclear medicine
Background:
- Coronary artery calcium (CAC) scoring via cardiac computed tomography (CT) is a validated method for assessing atherosclerotic burden and cardiovascular risk.
- Cardiac positron emission tomography (PET) uses computed tomography attenuation correction (ACCT) for image reconstruction, which has been visually used for CAC estimation.
- Quantitative CAC assessment using non-gated ACCT images from cardiac PET has not been previously described.
Purpose of the Study:
- To investigate the relationship between CAC measured by cardiac CT (CAC-CT) and CAC quantified from ACCT images obtained during cardiac PET perfusion imaging.
- To evaluate the feasibility and accuracy of quantifying CAC using ACCT images.
Main Methods:
- A retrospective analysis of 91 patients who underwent both CAC-CT and cardiac PET within a 6-month interval.
- CAC-CT images were scored using the Agatston method.
- ACCT images were scored using varying attenuation thresholds for calcium detection, with a focus on the 50 HU threshold (ACCT(50)).
- Interobserver reliability and correlation between CAC-CT and ACCT scores were assessed.
Main Results:
- Excellent interobserver reliability was achieved for CAC scoring at all tested detection thresholds.
- The strongest correlation between CAC-CT and ACCT was observed at the 50 HU threshold (ACCT(50)).
- High agreement was found between CAC-CT and ACCT(50) when categorized into standard CAC scores (0, 1-100, 101-400, >400).
- ACCT(50) tended to underestimate CAC as CAC-CT scores increased.
Conclusions:
- Quantification of CAC using ACCT images from cardiac PET is feasible and demonstrates accuracy.
- A single cardiac PET examination can provide comprehensive information including perfusion, LV function, flow quantification, and CAC without additional radiation.
- This integrated approach may enhance the diagnostic utility of cardiac PET imaging.
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