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Validation of a Length-Adjusted Abdominal Arterial Calcium Score Method for Contrast-Enhanced CT Scans

Raul Devia-Rodriguez1, Maikel Derksen1, Kristian de Groot1

  • 1Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands.

Diagnostics (Basel, Switzerland)
|June 10, 2023
PubMed

Insights

A new length-adjusted calcium score (LACS) method effectively quantifies arterial calcification on contrast-enhanced CT scans. This validated approach provides a reliable alternative for assessing calcium load in patients with atherosclerotic cardiovascular diseases.

Area of Science:

  • Radiology
  • Cardiovascular Imaging
  • Medical Physics

Background:

  • The Agatston score on noncontrast CT is the standard for calcium load assessment.
  • Contrast-enhanced CT is frequently used for atherosclerotic cardiovascular diseases (ASCVDs) like peripheral arterial occlusive disease (PAOD) and abdominal aortic aneurysm (AAA).
  • A validated method for determining aortic and peripheral arterial calcium load using contrast-enhanced CT is currently lacking.

Purpose of the Study:

  • To validate a novel length-adjusted calcium score (LACS) method for quantifying arterial calcification on contrast-enhanced computed tomography (CT) scans.
  • To establish a reliable tool for calcium load assessment in patients undergoing contrast-enhanced CT for ASCVDs.

Main Methods:

  • The length-adjusted calcium score (LACS) was calculated using contrast-enhanced CT scans from 30 patients without aortic disease.
  • A patient-specific Hounsfield unit (HU) threshold was used for contrast-enhanced CT segmentation, compared against a standard 130 HU threshold for noncontrast CT.
  • Interobserver variability and the effect of slice thickness (0.75 mm vs. 2.0 mm) on LACS were evaluated.

Main Results:

  • A high correlation (R2 = 0.98) was observed between LACS derived from contrast-enhanced CT and noncontrast CT.
  • A correction factor of 1.9 was determined to convert LACS from contrast-enhanced to noncontrast CT values.
  • Excellent interobserver agreement (1.0) for LACS on contrast-enhanced CT was found, with no significant difference in LACS calculation between different slice thicknesses.

Conclusions:

  • The length-adjusted calcium score (LACS) is a robust and validated method for assessing arterial calcium load on contrast-enhanced CT scans.
  • This method offers a reliable solution for evaluating calcification in arterial segments of varying lengths, particularly in patients with ASCVDs.
Abstract

Keywords:
atherosclerosiscalcified plaquescalcium scorefour-dimensional computed tomographyvascular diseases

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