ReviewThe international journal of cardiovascular imaging2015
The challenge of coronary calcium on coronary computed tomographic angiography (CCTA) scans: effect on interpretation and possible solutions.
Review in The international journal of cardiovascular imaging, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
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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.
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.
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Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- A meta-analysis comparing the diagnostic performance of computed tomography-derived fractional flow reserve and coronary computed tomography angiography at different levels of coronary artery calcium score.European radiology · 2024Pooled it
- Computed tomography angiography-derived fractional flow reserve (CT-FFR) for the detection of myocardial ischemia with invasive fractional flow reserve as reference: systematic review and meta-analysis.European radiology · 2020Pooled it
- Deep Learning-based Monoenergetic Imaging for Calcified Coronary Stenosis Assessment at Energy-integrating Detector CT.Radiology. Cardiothoracic imaging · 2026Article
- A Novel Cardiac Computed Tomography-Based Calcium Scoring System for Predicting the Use of Atherectomy Devices in Severely Calcified Coronary Lesions.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2025Observational
- The diagnostic performance of machine learning-based FFRCT for coronary artery disease: A meta-analysis.Open medicine (Warsaw, Poland) · 2025Article
- Correlation between CT-derived fractional flow reserve and myocardial strain in ischemic heart disease patients with single coronary artery stenosis assessed based on CCTA.Frontiers in cardiovascular medicine · 2025Article
- Evaluating machine learning accuracy in detecting significant coronary stenosis using CCTA-derived fractional flow reserve: Meta-analysis and systematic review.International journal of cardiology. Heart & vasculature · 2024Article
- Using artificial intelligence to study atherosclerosis from computed tomography imaging: A state-of-the-art review of the current literature.Atherosclerosis · 2024Review
- PCSK9 and Coronary Artery Plaque-New Opportunity or Red Herring?Current atherosclerosis reports · 2024Review
- [Assessment of Coronary Stenosis Using Coronary CT Angiography in Patients with High Calcium Scores: Current Limitations and Future Perspectives].Journal of the Korean Society of Radiology · 2024Review
- Utility of Coronary Computed Tomography Angiography in Patients Undergoing Transcatheter Aortic Valve Implantation: A Meta-Analysis and Meta-Regression Based on Published Data from 7458 Patients.Journal of clinical medicine · 2024Article
- The Value of Coronary Computed Tomography Angiography in Patients with a High Calcium Score.The journal of Tehran Heart Center · 2023Article
- Feasibility and accuracy of coronary artery calcium score on virtual non-contrast images derived from a dual-layer spectral detector CT: A retrospective multicenter study.Frontiers in cardiovascular medicine · 2023Article
- Evaluating the Coronary Artery Disease Consortium Model and the Coronary Artery Calcium Score in Predicting Obstructive Coronary Artery Disease in a Symptomatic Mixed Asian Cohort.Journal of the American Heart Association · 2022Article
- Diagnostic Accuracy of Subtraction Coronary CT Angiography in Severely Calcified Segments: Comparison Between Readers With Different Levels of Experience.Frontiers in cardiovascular medicine · 2022Article
- Incremental Diagnostic Value of CT Fractional Flow Reserve Using Subtraction Method in Patients with Severe Calcification: A Pilot Study.Journal of clinical medicine · 2021Article
- Understanding the predictive value and methods of risk assessment based on coronary computed tomographic angiography in populations with coronary artery disease: a review.Precision clinical medicine · 2021Review
- Subtraction improves the accuracy of coronary CT angiography for detecting obstructive disease in severely calcified segments.European radiology · 2021Article
- Diagnostic Accuracy and Generalizability of a Deep Learning-Based Fully Automated Algorithm for Coronary Artery Stenosis Detection on CCTA: A Multi-Centre Registry Study.Frontiers in cardiovascular medicine · 2021Article
- Artificial intelligence in cardiac radiology.La Radiologia medica · 2020Review
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Coronary calcium seen on coronary computed tomographic angiography (CCTA) scans is a common diagnostic challenge which can make interpretation difficult. It is the most common cause of false positive (FP) results from CCTA compared with invasive coronary angiography (ICA), and affects the positive predictive results. At the same time, coronary calcium can result in false negative (FN) results, and this again can affect the reported diagnostic accuracy of CCTA, as the high negative predictive value of CCTA compared to ICA is one of its strengths. This paper reviews the reasons that coronary calcium can cause FP and FN results, and the effects of the morphologies and sizes of the calcified plaques, with particular regard to their relationship with the visualization of the contrast-filled lumen of the coronary artery. Some possible solutions to overcome the limitations of reading CCTA scans with calcified plaques also are discussed, with a view to improving the accuracy of interpreting and reporting CCTA scans; these solutions include using the degree of residual visible contrast-filled lumen to help assess the likelihood of significant associated coronary stenosis, and applying newer technical developments such as dual-energy imaging and volume calcium subtraction.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.