ArticleEuropean radiology2021
Comparison of artery-based methods for ordinal grading of coronary artery calcium on low-dose chest computed tomography.
Article in European radiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 10 citations in OpenAlex.
- Prevalence and Severity of Coronary Artery Calcification Assessed by Low-Dose Computed Tomography in Individuals With Type 2 Diabetes With and Without Diabetic Foot: A Cross-Sectional Study.Journal of diabetes · 2026Article
- Visual coronary calcium scoring to support opportunistic CAD screening: comparative evaluation of three established systems and introduction of a novel scoring system.International journal of cardiology. Heart & vasculature · 2026Article
- Coronary artery calcium identified on non-gated chest computed tomography guides downstream coronary computed tomography angiography.Quantitative imaging in medicine and surgery · 2026Article
- The role of imaging in defining cardiovascular risk to help cancer patient management: a scoping review.Insights into imaging · 2025Review
- Correlation of Coronary Calcium Measured on Conventional Computed Tomography with Coronary Angiography Findings in Lung Transplant Patients.Tomography (Ann Arbor, Mich.) · 2025Article
- Coronary calcifications as assessed on routine non-gated chest CT; a gatekeeper to tailor downstream additional imaging in patients with stable chest pain.International journal of cardiology. Heart & vasculature · 2024Article
- The Clear Value of Coronary Artery Calcification Evaluation on Non-Gated Chest Computed Tomography for Cardiac Risk Stratification.Cardiology and therapy · 2024Review
- A Modified Length-Based Grading Method for Assessing Coronary Artery Calcium Severity on Non-Electrocardiogram-Gated Chest Computed Tomography: A Multiple-Observer Study.Korean journal of radiology · 2023Article
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Authors and funding
6 authors at 1 institution in 1 country.
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Abstract
objectivesTo identify the optimal artery-based method for ordinal grading of coronary artery calcium (CAC) on non-electrocardiogram (ECG)-gated low-dose chest computed tomography (LDCT) among three methods.
methodsA total of 120 asymptomatic subjects who underwent both LDCT and ECG-gated calcium scoring CT on the same day were retrospectively enrolled. Three cardiothoracic radiologists independently assessed CAC severity on LDCT (1.25-mm and 2.5-mm slice thickness) and classified it into four categories (none, mild, moderate, or severe) using three artery-based ordinal scoring methods (extent-based scoring, Weston scoring, and length-based scoring). Inter- and intra-observer CAC severity agreements of each method were assessed by Fleiss kappa statistics. Agreements between each method and ECG-gated calcium scoring CT were assessed by weighted kappa statistics.
resultsThe inter-observer agreement was highest with length-based method for both 1.25-mm (Fleiss kappa 0.735 for extent-based method, 0.801 for Weston score, and 0.813 for length-based method) and 2.5-mm slice thickness evaluation (Fleiss kappa 0.755 for extent-based method, 0.776 for Weston score, and 0.833 for extent-based method). Agreement across the three grading methods for the same observer was poor to moderate on 1.25-mm (Fleiss kappa 0.379-0.441) and moderate on 2.5-mm thickness evaluation (Fleiss kappa 0.427-0.461). Agreement of CAC severity between each method and ECG-gated calcium scoring CT was highest with the length-based method for all three observers on both 1.25-mm (weighted kappa 0.773-0.786) and 2.5-mm (weighted kappa 0.794-0.825) LDCT images.
conclusionAmong the three artery-based ordinal grading methods, the length-based method appears to be the most reliable for evaluating CAC on non-ECG-gated LDCT. KEY POINTS: • The length-based method showed the highest inter-observer agreement and the highest agreement with the ECG-gated calcium scoring CT, compared with the extent-based method and the Weston score.
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