Related Experiment Video
Updated: Jan 20, 2026
Author Spotlight: Advancing Cardiovascular Imaging - Introducing the Spatially Weighted Calcium Score for Early Disease Detection
Published on: September 22, 2023
Efficacy of Computed Tomography Calcium (CT Ca) Score as a Screening Tool for Coronary Artery Disease in Wait Listed
Joy Varghese1, Mukhil Rajendran1, P Dinu Abirami1
1Institute of Liver Disease & Transplantation and Department of Radiodiagnosis, Gleneagles Hospitals, Chennai, India.
Insights
The CT coronary calcium (CT Ca) score offers a non-invasive method for assessing coronary artery disease (CAD) severity in liver transplant candidates. It shows fair agreement with coronary angiogram (CAG), proving useful for initial obstructive/non-obstructive CAD evaluation.
Area of Science:
- Cardiology
- Radiology
- Transplant Surgery
Background:
- Coronary artery disease (CAD) assessment is crucial for liver transplant (LT) recipients.
- Coronary angiogram (CAG) is the gold standard but invasive.
- CT coronary calcium (CT Ca) score is a non-invasive alternative.
Purpose of the Study:
- To compare the efficacy of CT Ca score with CAG in predicting CAD severity.
- To evaluate CT Ca score's utility in pre-liver transplant (LT) recipient work-up.
Main Methods:
- CT Ca score was performed on all listed patients.
- CAG was reserved for patients >50 years or with CT Ca score >400 HU.
- Coronary stenosis severity was graded using CAG findings.
Main Results:
- 158 patients had both CT Ca score and CAG.
- CT Ca score showed a fair agreement with CAG (Weighted Cohen's Kappa = 0.258).
- Accuracy was higher for obstructive/non-obstructive CAD classification (70.89%) compared to normal/abnormal (60.13%).
Conclusions:
- CT Ca score is a convenient, non-invasive tool for initial CAD assessment in LT recipients.
- It aids in differentiating obstructive from non-obstructive CAD.
- This supports its use in pre-transplant evaluations.
Abstract:
CT coronary calcium (CT Ca) score is a non-invasive method for assessing presence and severity of CAD in an individual. Coronary angiogram (CAG) is an invasive procedure and remains the gold standard for diagnosis of coronary artery disease (CAD).
Aim:
To compare the efficacy of CT Ca score with CAG, for predicting severity of CAD during pre liver transplant (LT) recipient work-up.
Methods:
CT Ca score was done for all listed patients. CAG was reserved for those >50 years or a CT Ca score >400 HU (Agtston scoring system). The severity of coronary artery stenosis by CAG was graded as normal, mild (<50% stenosis), moderate (50-75% stenosis, severe (>75 % stenosis) and extensive (> one major coronary artery) was involved.
Statistical Analysis:
Weighted Cohen's Kappa was used to assess the agreement between the CT Ca score and CAG for ordinal outcome. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, negative predictive value and diagnostic accuracy) were calculated for CT Ca score considering CAG classification as the gold-standard. RStudio Desktop latest version was used for analysis.
Results:
158 patients had both CT Ca score and CAG. There was a significant overlap between CT Ca score and CAG score in detecting CAD. Comparing CT Ca score and CAG, 70 patients were correctly classified (44.3%) by the former, 66 (41.8%) were over-classified and 22 (13.9%) were under-classified. Overall, there was a statistically significant fair agreement between CT CA score and CAG severity index (Weighted Cohen's Kappa = 0.258; 95% CI: 0.140 to 0.377; P < 0.001). The accuracy with CT Ca score was higher (70.89%) for obstructive/non-obstructive CT Ca score i.e. >100 HU) compared to the abnormal/normal CT Ca scores (60.13%). For obstructive/non obstructive classification, CT Ca score was significant for past CAD (0.004).
Conclusions:
CT Ca score provides a convenient and non-invasive method for the initial assessment of obstructive/non obstructive CAD in liver transplant recipients.
Related Concept Videos
06:57Semi-Automatic Graphical Tool for Measuring Coronary Artery Spatially Weighted Calcium Score from Gated Cardiac Computed Tomography Images
04:40Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
06:16Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
09:23Successful Orthotopic Liver Transplantation in Mice Utilizing Microcomputed Tomography Angiography
08:41Novel In Vivo Micro-Computed Tomography Imaging Techniques for Assessing the Progression of Non-Alcoholic Fatty Liver Disease
08:39Reduced Complications after Arterial Reconnection in a Rat Model of Orthotopic Liver Transplantation