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Updated: Sep 9, 2025
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Impact of the ADMIRE reconstruction algorithm combined with the Sa36 kernel on quantitative measurement of coronary
Huayang Du1, Quanyu He2, Jia Ren3
1Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Sichuan, China.
Purpose:
Accurate quantification of coronary artery calcium (CAC) via computed tomography (CT) imaging is essential for effective cardiovascular risk assessment. This study investigates the impact of different iteration levels in the advanced model-based iterative reconstruction (ADMIRE) algorithm on artificial intelligence-driven CAC quantification and subsequent risk stratification, with filtered back projection (FBP) serving as the reference.
Material And Methods:
For 254 patients undergoing coronary CT angiography (120 kVp, automated tube current), raw data were reconstructed using FBP and ADMIRE levels 1-5 (kernel Sa36, 3.0 mm slice thickness, 1.5 mm spacing). AI-derived CAC parameters (volume, mass, Agatston score) and risk stratification were compared across reconstruction groups. Statistical analysis employed the Friedman test, one-way analysis of variance, and c2 test.
Results:
Compared to FBP, ADMIRE 1-5 reduced image noise by 9.70% to 49.76% (noise: 14.95 ± 2.26 HU vs. 7.55 ± 1.40 HU, F = 455.105, p < 0.001). Maximum CAC CT values progressively decreased with higher ADMIRE levels (FBP: 458.50 [306.00-645.00] HU vs. ADMIRE 5: 432.50 [281.75-620.75] HU; χ2 = 455.105, p < 0.001). CAC volume, mass, and Agatston scores declined significantly (p < 0.001 for all): volume decreased by 8.56-32.55% (FBP: 47.56 ± 5.93 mm3 vs. ADMIRE 5: 21.77 ± 3.46 mm3; F = 32.310); mass decreased by 8.73-32.57% (F = 29.477); and Agatston scores decreased by 8.77-33.13% (F = 31.104). Risk stratification shifted in 24/161 patients (14.91%) with detectable CAC. The effective radiation dose was 0.61 ± 0.18 mSv.
Conclusions:
ADMIRE reconstruction reduces image noise but progressively lowers CAC quantification (volume, mass, Agatston score) and maximum CT values, leading to underestimation of cardiovascular risk in a subset of patients. Caution is warranted when applying ADMIRE iterative reconstruction for CAC scoring.
