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Novel Quantification Protocol for Cardiovascular Calcification Progression Using Longitudinal MicroPET/MicroCT Images
Published on: November 15, 2024
Quantification of lower leg arterial calcifications by high-resolution peripheral quantitative computed tomography
Janina M Patsch1, Martin A Zulliger, Nicolas Vilayphou
1Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria.
Bone
|August 20, 2013
Summary
A new semi-automated algorithm accurately quantifies lower leg arterial calcifications (LLACs) using high-resolution peripheral quantitative computed tomography (HR-pQCT). This validated method shows LLACs correlate with coronary artery calcifications and are associated with diabetes and stroke in dialysis patients.
Area of Science:
- Osteo-vascular Biology
- Medical Imaging
- Nephrology
Background:
- Vascular calcifications and bone health share risk factors like aging and inflammation.
- Low bone mineral density (BMD) and fractures are linked to arterial calcifications.
- High-resolution peripheral quantitative computed tomography (HR-pQCT) assesses bone but incidentally captures vascular calcifications.
Purpose of the Study:
- To develop and validate a semi-automated algorithm for quantifying lower leg arterial calcifications (LLACs) from HR-pQCT scans.
- To assess the validity and reliability of the LLAC measurement.
- To explore associations between LLACs and clinical factors in patients undergoing chronic hemodialysis.
Main Methods:
- A semi-automated, dual-threshold seed-point segmentation algorithm was developed to quantify LLACs from HR-pQCT scans (250μm voxel size).
- LLAC mass was calculated based on calcification volume and density (mg hydroxyapatite; HA).
- Validity was assessed by comparing LLACs with coronary artery calcifications (CACs) using multi-detector computed tomography (MDCT) and Agatston scoring in 46 hemodialysis patients. Reliability was tested for intra- and inter-reader agreement.
Main Results:
- LLACs were present in 76% of patients, correlating significantly with CACs (rho=0.6; p<0.01).
- Higher LLACs were observed in patients with type-2 diabetes mellitus (20.0 fold greater, p=0.006) and history of stroke (5.1 fold greater, p=0.047).
- LLACs showed a positive correlation with time on dialysis (rho=0.337, p=0.029) and a trend with age (rho=0.289, p=0.053). Intra- and inter-reader reliability were excellent (ICC > 0.998).
Conclusions:
- The developed semi-automated LLAC measure demonstrates good validity and excellent reliability.
- HR-pQCT can simultaneously assess peripheral bone and arterial calcifications, facilitating research on osteo-vascular interactions.
- This method holds potential for evaluating cardiovascular risk in patients with bone disease.
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