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Updated: Aug 6, 2026

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
04:40

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans

Published on: August 28, 2018

Thoracic vertebral CT-based bone health indicator from coronary calcium scoring: correlation with CAD and prognostic

Naoki Onoda1, Satoshi Nakamura2, Naoki Hashimoto1

  • 1Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.

BMC Cardiovascular Disorders
|July 17, 2026
PubMed

Insights

Computed tomography-based bone health indicator (CT-BHI) from coronary calcium scoring images can predict coronary artery disease severity and mortality risk. This opportunistic marker offers integrated cardiovascular and skeletal risk assessment without extra cost or radiation.

Area of Science:

  • Radiology
  • Cardiology
  • Bone Health

Background:

  • Lower thoracic vertebral attenuation on coronary artery calcium scoring images can serve as an opportunistic computed tomography-based bone health indicator (CT-BHI).
  • This study investigated the association between CT-BHI, coronary artery disease (CAD) severity, and all-cause mortality.

Purpose of the Study:

  • To evaluate the association of CT-BHI with coronary artery disease (CAD) severity.
  • To assess the association of CT-BHI with all-cause mortality.

Main Methods:

  • Retrospective analysis of 767 patients with suspected CAD who underwent coronary CT angiography (CCTA) and coronary calcium scoring.
  • CT attenuation of lower thoracic vertebrae was measured to derive CT-BHI, with patients categorized into tertiles.
  • Exclusion criteria included prior myocardial infarction or revascularization.

Main Results:

  • Lower CT-BHI was significantly associated with higher coronary calcium scores (p < 0.001).
  • CAD severity distribution differed significantly across CT-BHI tertiles (p = 0.037), with lower prevalence of normal coronary arteries in the low CT-BHI group.
  • CT-BHI independently predicted mortality and improved risk classification when added to calcium scores (p < 0.05).

Conclusions:

  • CT-BHI derived from routine calcium scoring images offers a dual-purpose opportunistic marker for integrated cardiovascular and skeletal risk assessment.
  • This method avoids additional radiation exposure and costs.
  • Further validation against standardized bone density measurements is needed to define its clinical utility.
Abstract

Keywords:
Computed tomographyCoronary artery calciumMortalityOsteoporosisRisk stratification

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