Assessment of Coronary Artery Calcium on Low-Dose Coronary Computed Tomography Angiography With Iterative Reconstruction
Braber, Thijs L; Willemink, Martin J; Bohté, Elzemiek H; Mosterd, Arend; Leiner, Tim; Velthuis, Birgitta K
(2016) Journal of Computer Assisted Tomography, volume 40, issue 2, pp. 266 - 271
(Article)
Abstract
OBJECTIVE: This study aims to evaluate whether coronary calcium scoring (CCS) is also feasible using low-radiation-dose coronary computed tomography angiography (CCTA) in combination with iterative reconstruction. METHODS: Forty-three individuals without known coronary artery disease underwent both noncontrast CCS (±1 mSv) for reference Agatston scores and low-dose CCTA (±3 mSv). Raw
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CCTA data were reconstructed with filtered back projection (FBP), hybrid iterative reconstruction (HIR), and model-based iterative reconstruction (MIR). Calcification volumes were derived with thresholds of >351 and >600 Hounsfield units (HU) and converted to proxy Agatston scores with linear regression analysis. RESULTS: Intraclass correlation coefficients for Agatston scores versus CCTA volumes with FBP and iterative reconstruction were excellent (ranges 0.94-0.99 and 0.96-0.99 for >351 HU and >600 HU thresholds, respectively). The >351 HU threshold resulted in higher CCTA volume scores ranging from 65.9 (15.1-347.0) for HIR to 94.8 (42.0-423.0) for MIR (P = 0.001 and <0.001, respectively). The >600 HU threshold scores ranged from 14.1 (0.0-159.3) for HIR to 28.6 (0.0-215.6) for MIR (P = 0.003 and 0.027, respectively). At >351 HU, reclassification occurred in 21 individuals (49%) for FBP and HIR and 25 individuals (58%) for MIR. Reclassifications decreased with >600 HU to 10 (HIR, 23%), 8 (FBP, 19%), and 4 (MIR, 9%). CONCLUSIONS: The CCS is feasible using iteratively reconstructed low-dose CCTA with a calcium threshold of >600 HU. Using MIR, only 9% of individuals were reclassified.
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Author keywords: Calcinosis, Calcium, coronary CT angiography, Coronary Vessels, Feasibility Studies, Female, coronary artery calcium score, Image Processing, Computer-Assisted, low dose, Middle Aged, Radiation Dosage, Radiographic Image Interpretation, Computer-Assisted, Reproducibility of Results, Retrospective Studies, Tomography, X-Ray Computed, iterative reconstruction, dose reduction, Journal Article
ISSN: 0363-8715
(Publisher version, Peer reviewed)