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Association Between AI-derived Thoracic Calcium Volume and Aortic Valve Calcification Quantified by Agatston Scoring.
Gonçalo G Almeida1, Dana Belde1,2, Mike Guldimann1,3
1Department of Radiology, Kantonsspital Baden, affiliated Hospital for Research and Teaching of the Faculty of Medicine of the University of Zurich, Baden, Switzerland.
In Vivo (Athens, Greece)
|February 27, 2026
Summary
Artificial intelligence (AI)-derived thoracic aortic calcium volume does not correlate with aortic valve calcification. This suggests valvular calcification progresses independently, and AI measurements cannot replace direct valve assessment.
Area of Science:
- Cardiology
- Radiology
- Artificial Intelligence in Medicine
Background:
- Aortic valve calcification is crucial for determining aortic stenosis severity.
- The utility of AI-derived thoracic aortic calcium volume in reflecting valvular calcification is not well-established.
- This study investigates the relationship between AI-measured aortic calcium and direct valvular calcification quantification.
Purpose of the Study:
- To examine the association between aortic valve calcification (quantified by Agatston, volume, and mass scores) and total aortic calcium volume measured by an automated AI tool.
- To determine if AI-derived thoracic aortic calcium volume can serve as a surrogate for valvular calcification assessment.
Main Methods:
- Retrospective single-center study of 32 patients undergoing CT for transcatheter aortic valve implantation planning.
- Aortic valve calcification quantified using Agatston, volume, and mass scores on noncontrast CT.
- Total aortic calcium volume measured from contrast-enhanced CT using the AI-Rad Companion Chest CT tool.
- Correlation analyses and simple linear regression used to assess associations.
Main Results:
- Mean total aortic calcium volume was 4.38 ml.
- Mean aortic valve Agatston score was 3307 units; mean valve calcium volume was 2727 mm³.
- Weak, nonsignificant correlations were found between total aortic calcium and aortic valve calcification metrics (Pearson r ≈ 0.21, p > 0.24).
- Regression models showed minimal explained variance (R² ≈ 4-5%), indicating no clinically relevant association.
Conclusions:
- AI-derived thoracic aortic calcium volume does not correlate with aortic valve calcification.
- Aortic valve calcification appears to progress independently of thoracic aortic wall calcification.
- Automated thoracic aortic calcium measurements are not a substitute for direct aortic valve calcification quantification in preprocedural assessments.
Keywords:
Aortic valve stenosisaortic valve calcificationcalcium scoringcomputed tomographytranscatheter aortic valve replacementMore Related Videos
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