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Updated: Sep 30, 2025

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

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What should we do about Coronary Calcification on Thoracic CT?

Oliver Llewellyn1, Michelle C Williams2

  • 1Department of Radiology, Royal Infirmary of Edinburgh, United Kingdom of Great Britain and Northern Ireland.

Rofo : Fortschritte Auf Dem Gebiete Der Rontgenstrahlen Und Der Nuklearmedizin
|March 10, 2022
PubMed

Insights

Coronary artery calcification found on non-cardiac CT scans indicates higher cardiac risk. Reporting this incidental finding is recommended by guidelines and can prompt crucial cardiovascular risk assessments.

Area of Science:

  • Radiology
  • Cardiology
  • Preventive Medicine

Background:

  • Coronary artery calcification (CAC) is often incidentally detected on thoracic computed tomography (CT) scans ordered for non-cardiac reasons.
  • On electrocardiogram-gated cardiac CT, CAC is a recognized indicator of coronary artery disease (CAD) and predicts future cardiac events.

Purpose of the Study:

  • This review synthesizes current evidence and guidelines on reporting CAC identified in non-electrocardiogram-gated thoracic CT scans.
  • To evaluate the clinical significance of incidental CAC findings in patients undergoing thoracic CT for non-cardiac indications.

Main Methods:

  • Literature review of current evidence and guidelines.
  • Analysis of the association between CAC on thoracic CT and cardiovascular outcomes.
  • Comparison of CAC assessment on non-gated versus gated CT.

Main Results:

  • CAC on routine thoracic CT is linked to increased risk of myocardial infarction and mortality.
  • CAC can be reliably assessed on non-gated thoracic CT, comparable to gated CT.
  • Guidelines advocate for reporting CAC found on thoracic CT, though radiologist consensus varies.
  • Incidental CAC detection can identify individuals with previously unrecognized CAD, potentially leading to risk factor assessment and preventive treatment.

Conclusions:

  • Reporting incidental CAC on thoracic CT is supported by guidelines and can facilitate early cardiovascular risk stratification.
  • Future research should explore the impact of management changes based on thoracic CT-detected CAC and investigate automated CAC assessment using machine learning.
Abstract

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