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Updated: May 11, 2026

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
04:40

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans

Published on: August 28, 2018

Severe aortic arch calcification depicted on chest radiography strongly suggests coronary artery calcification

Peter Bannas1, Caroline Jung, Philipp Blanke

  • 1Department of Diagnostic and Interventional Radiology, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany, p.bannas@uke.de.

European Radiology
|May 11, 2013
PubMed

Insights

Semi-quantitative grading of aortic arch calcifications (AAC) on chest X-rays is reliable and correlates with coronary artery calcium (CAC) scores. Severe AAC on radiography suggests significant coronary artery calcification, aiding in risk assessment.

Area of Science:

  • Radiology
  • Cardiovascular Imaging
  • Diagnostic Accuracy

Background:

  • Aortic arch calcifications (AAC) are visible on chest radiography.
  • Coronary artery calcium (CAC) scoring via CT is a standard for cardiovascular risk assessment.
  • The relationship between AAC on radiography and CAC scores needs further clarification.

Purpose of the Study:

  • To evaluate the association between aortic arch calcifications (AAC) on chest radiography and coronary artery calcium (CAC) scores determined by CT.
  • To assess the reliability and diagnostic performance of semi-quantitative AAC grading on chest radiography.

Main Methods:

  • Retrospective analysis of 128 patients who underwent both chest radiography and CT CAC scoring.
  • Independent blinded evaluation of AAC extent on chest radiography using a semi-quantitative four-point scale.
  • Assessment of intra- and interobserver agreement using weighted kappa statistics and correlation with CAC scores.

Main Results:

  • Excellent intraobserver (κ=0.82) and good interobserver (κ=0.75) agreement for AAC grading.
  • Moderate agreement (κ=0.46) between AAC grades and CAC scores with a significant linear trend (P<0.0001).
  • AAC grade cutoff (0-2 vs. 3) showed 38.6% sensitivity and 96.4% specificity for CAC scores >400.

Conclusions:

  • Semi-quantitative AAC grading on chest radiography is a reliable method.
  • AAC grading on chest radiography is positively associated with CAC scores.
  • Severe AAC on chest radiography strongly suggests significant coronary artery calcification, warranting reporting in radiological reports.
Abstract

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