Evidence map›Paper›PMID 26253256›Full record

ArticleEuropean radiology2016

Technical feasibility and validation of a coronary artery calcium scoring system using CT coronary angiography images.

Christopher W Pavitt, Katie Harron, Alistair C Lindsay, Sayeh Zielke, Robin Ray, Daniel Gordon, Michael B Rubens, Simon P Padley, Edward D Nicol

Abstract readEvaluation Study
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In one paragraph

Article in European radiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Christopher W PavittDepartment of Cardiology, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.
Katie HarronCentre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, UCL, London, WC1N 1EH, UK.
Alistair C LindsayDepartment of Cardiology, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.
Sayeh ZielkeDepartment of Radiology, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.
Robin RayDepartment of Cardiology, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.
Daniel GordonDepartment of Physics, Royal Marsden Hospital, Fulham Rd, London, SW3 6JJ, UK.
Michael B RubensDepartment of Radiology, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.
Simon P PadleyDepartment of Radiology, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.
Edward D NicolDepartment of Cardiology, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK. e.nicol@rbht.nhs.uk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesWe validate a novel CT coronary angiography (CCTA) coronary calcium scoring system.

methodsCalcium was quantified on CCTA images using a new patient-specific attenuation threshold: mean + 2SD of intra-coronary contrast density (HU). Using 335 patient data sets a conversion factor (CF) for predicting CACS from CCTA scores (CCTAS) was derived and validated in a separate cohort (n = 168). Bland-Altman analysis and weighted kappa for MESA centiles and Agatston risk groupings were calculated.

resultsMultivariable linear regression yielded a CF: CACS = (1.185 × CCTAS) + (0.002 × CCTAS × attenuation threshold). When applied to CCTA data sets there was excellent correlation (r = 0.95; p < 0.0001) and agreement (mean difference -10.4 [95% limits of agreement -258.9 to 238.1]) with traditional calcium scores. Agreement was better for calcium scores below 500; however, MESA percentile agreement was better for high risk patients. Risk stratification was excellent (Agatston groups k = 0.88 and MESA centiles k = 0.91). Eliminating the dedicated CACS scan decreased patient radiation exposure by approximately one-third.

conclusionCCTA calcium scores can accurately predict CACS using a simple, individualized, semiautomated approach reducing acquisition time and radiation exposure when evaluating patients for CAD. This method is not affected by the ROI location, imaging protocol, or tube voltage strengthening its clinical applicability. KEY POINTS: • Coronary calcium scores can be reliably determined on contrast-enhanced cardiac CT • This score can accurately risk stratify patients • Elimination of a dedicated calcium scan reduces patient radiation by a third.

Indexed as

AgedCoronary AngiographyCoronary DiseaseCoronary VesselsFeasibility StudiesFemaleHumansMaleMultidetector Computed TomographyObserver VariationRadiation DosageReproducibility of ResultsVascular CalcificationAgatston scoreCalcium scoringCardiac CTCardiovascular riskCT coronary angiography

Identifiers

PMID26253256

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