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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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Aortic Valve Calcium Scoring Using True and Virtual Non-Contrast Reconstructions on Photon-Counting CT with Differing

Mandeep Singh1,2, Amirhossein Moaddab1,3, Doosup Shin1

  • 1Department of Cardiology, St Francis Hospital & Heart Center, Roslyn, NY 11576, USA.

Tomography (Ann Arbor, Mich.)
|December 24, 2025
PubMed
Summary

Virtual non-contrast (VNC) reconstructions on photon-counting detector CT (PCD-CT) show high reproducibility for evaluating aortic valve calcification (AVC). This VNC method offers a reliable alternative to true non-contrast (TNC) CT for assessing AVC with excellent diagnostic accuracy.

Keywords:
aortic valve calcium scorecomputed tomographyphoton-counting detector-computed tomographyslice thicknesstrue non contrastvirtual non contrast

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Area of Science:

  • Radiology and Imaging Science
  • Cardiovascular Imaging
  • Medical Physics

Background:

  • Aortic valve calcification (AVC) is routinely assessed using 3.0 mm true non-contrast (TNC) computed tomography (CT).
  • Photon-counting detector CT (PCD-CT) enables virtual non-contrast (VNC) reconstructions, offering potential advantages in imaging efficiency and radiation dose reduction.
  • Evaluating the reproducibility of VNC reconstructions at varying slice intervals is crucial for clinical adoption.

Purpose of the Study:

  • To assess the reproducibility of VNC reconstructions at 3.0 mm and 1.5 mm slice intervals compared to TNC CT for aortic valve calcium scoring (AVCS).
  • To determine the diagnostic accuracy of VNC in classifying severe aortic valve calcification.

Main Methods:

  • Retrospective analysis of 279 patients who underwent PCD-CT for native aortic valve evaluation.
  • Comparison of aortic valve calcium score (AVCS) and volume (AVCV) between TNC and VNC images reconstructed at 3.0 mm and 1.5 mm intervals.
  • Statistical analysis included paired t-tests, inter-class coefficients (ICCs) for continuous variables, and Cohen's Kappa (κ) for severe calcification classification.

Main Results:

  • VNC reconstructions showed no significant difference in AVCS compared to TNC, with excellent reproducibility (ICC 0.970-0.977).
  • TNC images at 1.5 mm intervals showed higher AVCS than the standard 3.0 mm TNC, but with high reproducibility.
  • Strong concordance (κ = 0.81-0.83) was observed between VNC and TNC methods in diagnosing severe AV calcification, with low misclassification rates.

Conclusions:

  • Virtual non-contrast (VNC) reconstructions at 3.0 mm and 1.5 mm intervals using PCD-CT provide highly reproducible aortic valve calcium scoring (AVCS).
  • VNC serves as a reliable alternative to traditional TNC CT for AVC evaluation, demonstrating excellent diagnostic accuracy.
  • The findings support the clinical utility of VNC in cardiovascular imaging protocols.