Related Experiment Video
Updated: Nov 9, 2025
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Reliability of Coronary Artery Calcium Severity Assessment on Non-Electrocardiogram-Gated CT: A Meta-Analysis
Jin Young Kim1, Young Joo Suh2, Kyunghwa Han3
1Department of Radiology, Dongsan Hospital, Keimyung University College of Medicine, Daegu, Korea.
Insights
Electrocardiogram (ECG)-gated and non-ECG-gated CT show excellent agreement for coronary artery calcium (CAC) severity. Scan parameters like slice thickness and reconstruction kernel significantly impact CAC measurement accuracy.
Area of Science:
- Cardiovascular Imaging
- Radiology
- Medical Diagnostics
Background:
- Coronary artery calcium (CAC) scoring is crucial for cardiovascular risk assessment.
- Electrocardiogram (ECG)-gated CT is traditionally used for accurate CAC assessment.
- Non-ECG-gated CT offers faster scan times but its agreement with ECG-gated CT requires evaluation.
Purpose of the Study:
- To perform a meta-analysis on the pooled agreement of CAC severities between ECG-gated and non-ECG-gated CT.
- To evaluate the impact of specific scan parameters on CAC measurement agreement.
Main Methods:
- Systematic literature search of PubMed, EMBASE, and Cochrane Library.
- Meta-analysis of 16 studies including 4000 patients.
- Quality assessment using a modified DTA-2 tool.
- Subgroup analyses based on slice thickness, reconstruction kernel, and radiation dose.
Main Results:
- Excellent pooled agreement for CAC scores (correlation coefficient=0.94) and severity categorization (weighted kappa=0.85).
- Significant heterogeneity observed across studies (I² > 50%).
- Improved agreement noted when CT reconstructions used identical slice thickness and kernel.
Conclusions:
- ECG-gated and non-ECG-gated CT demonstrate excellent pooled agreement for CAC severity.
- Scan parameters, specifically slice thickness and reconstruction kernel, significantly influence the agreement between the two CT modalities.
Objective:
The purpose of this meta-analysis was to investigate the pooled agreements of the coronary artery calcium (CAC) severities assessed by electrocardiogram (ECG)-gated and non-ECG-gated CT and evaluate the impact of the scan parameters.
Materials And Methods:
PubMed, EMBASE, and the Cochrane library were systematically searched. A modified Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to evaluate the quality of the studies. Meta-analytic methods were utilized to determine the pooled weighted bias, limits of agreement (LOA), and the correlation coefficient of the CAC scores or the weighted kappa for the categorization of the CAC severities detected by the two modalities. The heterogeneity among the studies was also assessed. Subgroup analyses were performed based on factors that could affect the measurement of the CAC score and severity: slice thickness, reconstruction kernel, and radiation dose for non-ECG-gated CT.
Results:
A total of 4000 patients from 16 studies were included. The pooled bias was 62.60, 95% LOA were -36.19 to 161.40, and the pooled correlation coefficient was 0.94 (95% confidence interval [CI] = 0.89-0.97) for the CAC score. The pooled weighted kappa of the CAC severity was 0.85 (95% CI = 0.79-0.91). Heterogeneity was observed in the studies (I² > 50%, p < 0.1). In the subgroup analysis, the agreement between the CAC categorizations was better when the two CT examinations had reconstructions based on the same slice thickness and kernel.
Conclusion:
The pooled agreement of the CAC severities assessed by the ECG-gated and non-ECG-gated CT was excellent; however, it was significantly affected by scan parameters, such as slice thickness and the reconstruction kernel.
More Related Videos
06:57Author Spotlight: Advancing Cardiovascular Imaging - Introducing the Spatially Weighted Calcium Score for Early Disease Detection
Published on: September 22, 2023
06:16Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
Published on: August 9, 2024
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...
01:21Imaging Studies for Cardiovascular System IV: CMRI
01:30Acute Coronary Syndrome I: Introduction