Ultrafast computed tomography for detection of coronary artery calcification

This review summarizes coronary artery calcification as a marker of coronary atherosclerosis as historically noted and detected with radiographic imaging modalities. This review concentrates on the use of ultrafast computed tomography (CT) for coronary artery calcification imaging. Ultrafast CT is uniquely qualified for imaging of the coronary arteries and calcific deposits in particular because of the x-ray attenuation characteristics of calcium. Current validation studies are summarized. In particular, the sensitivity of ultrafast CT coronary calcification in angiographically proven obstructive disease has been shown by many investigators to be above 90%, but with specificity on the order of 40% to 50%. These numbers may be different for younger men and women, where the detection of smaller calcific deposits is more difficult. The positive predictive value has been calculated as between 72% by angiographic validation and 40% in a population with a lower pretest bias.