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Updated: May 15, 2026
04:40
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Improved coronary CT angiography image quality using photon-counting detector CT in SCAPIS reexamination: scan
Mats Lidén1, Gusten Nyberg2, Marie-Louise Aurumskjöld3
1Dept of Radiology and Medical Physics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
European Journal of Radiology
|May 13, 2026
Summary
The Swedish CArdioPulmonary bioImage Study reexamination (SCAPIS reexamination) used photon-counting detector CT (PCD-CT) to achieve superior coronary CT angiography (CCTA) image quality compared to baseline. Agatston scores were comparable, but stenosis grading requires further study.
Area of Science:
- Cardiovascular Imaging
- Medical Physics
- Radiology
Background:
- The Swedish CArdioPulmonary bioImage Study (SCAPIS) baseline utilized energy-integrating detector CT (EID-CT) for coronary CT angiography (CCTA).
- The SCAPIS reexamination introduces photon-counting detector CT (PCD-CT) for CCTA in a population-based cohort.
Purpose of the Study:
- To detail the PCD-CT protocol implemented in the SCAPIS reexamination.
- To compare the diagnostic image quality of PCD-CT in SCAPIS reexamination against EID-CT from SCAPIS baseline.
- To evaluate the comparability of Agatston scores and coronary artery stenosis degree between the two study phases.
Main Methods:
- The PCD-CT protocol for SCAPIS reexamination is described.
- CCTA data from 1,147 participants in SCAPIS reexamination and 29,554 in SCAPIS baseline were analyzed.
- Image quality was compared across 11 coronary segments, stratified by Agatston score. Agatston scores and stenosis severity were compared in matched samples.
Main Results:
- Full diagnostic image quality was achieved in 90% of SCAPIS reexamination participants versus 78% in SCAPIS baseline (p < 0.001), despite a higher calcium burden in the reexamination group.
- For participants with Agatston scores > 400, image quality was 77% in SCAPIS reexamination compared to 26% in SCAPIS baseline (p < 0.001).
- Agatston score distributions and prevalence of ≥50% stenosis were similar between matched samples (p=0.51 and p=0.08, respectively). However, 30% of participants with ≥50% stenosis at baseline were reclassified to <50% stenosis in the reexamination.
Conclusions:
- The optimized PCD-CT protocol in SCAPIS reexamination yields high image quality, surpassing the EID-CT protocol from SCAPIS baseline, regardless of coronary artery calcification.
- Agatston scores demonstrated comparability between the two study phases.
- Potential discrepancies in stenosis grading necessitate further investigation.
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