title: Small lesions in the heart identified at electron beam CT: calcification or noise?
abstract: OBJECTIVE
  To identify a minimum definition of coronary artery calcification (CAC) at electron beam computed tomography (CT) that would give repeatable results and be accurate as a marker for coronary artery disease.
  
  
  METHODS
  Hyperattenuating (> 130 HU) foci 0.69-3.09 mm2 in area were evaluated for 256 subjects who underwent two sequential electron beam CT examinations to determine the percentage of hyperattenuating foci seen on a first examination that were seen again on a second examination. Accuracies of varying minimum definitions of CAC were determined in 160 subjects who underwent electron beam CT and coronary arteriography.
  
  
  RESULTS
  Hyperattenuating foci more than 2 mm2 in area were seen again at a second examination in more than 50% of cases (P < .0001). At this minimum definition of CAC, the sensitivity and specificity for identifying any angiographically defined coronary artery disease were 82% and 85%, respectively.
  
  
  CONCLUSIONS
  The 2-mm2-area definition of CAC was reliable and provided an accurate indication of coronary artery disease.
authors.affiliation: Department of Epidemiology, University of Michigan, Ann Arbor.
authors.forename: L F
authors.initials: LF
authors.lastname: Bielak
authors.forename: R B
authors.initials: RB
authors.lastname: Kaufmann
authors.forename: P P
authors.initials: PP
authors.lastname: Moll
authors.forename: C H
authors.initials: CH
authors.lastname: McCollough
authors.forename: R S
authors.initials: RS
authors.lastname: Schwartz
authors.forename: P F
authors.initials: PF
authors.lastname: Sheedy
mesh_terms: D000328:Adult; D016477:Artifacts; D002114:Calcinosis / Q000000981:diagnostic imaging*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed