Coronary artery calcium scoring: diagnostic accuracy of different software implementations.
OBJECTIVE
To compare the diagnostic power of different software implementations for the quantification of coronary artery calcium.


METHODS
Electron beam computed tomography was performed in 109 heart transplant recipients at the same time as catheter coronary angiography and intracoronary ultrasound. Electron beam computed tomography images were analyzed by 3 software packages marketed for the quantification of coronary calcifications using the same software settings, and the resultant calcium scores correlated with the invasive reference methods by Bland-Altman plots and analysis of the receiver operating characteristics.


RESULTS
Although all scoring systems displayed close correlations upon regression analysis (r2=0.94-0.99), their ability to detect disease as per the invasive reference method varied significantly in some instances. The area under the ROC curve varied between Az=0.78 and 0.85 for the detection of coronary artery stenosis upon coronary angiography (P=0.05-0.13), and between Az=0.75 and 0.83 for the detection of accelerated intimal proliferation (P=0.03-0.18).


CONCLUSIONS
Different software implementations for the quantification of coronary artery calcium load may display diagnostically relevant differences in spite of close direct correlation.
Knollmann
Friedrich D
FD
Department of Radiology, Charité, Campus Virchow-Klinikum, Humboldt-University, Berlin, Germany. Friedrich.Knollman@charite.de
Helmig
Klaus
K
Kapell
Susanne
S
Hummel
Manfred
M
Bocksch
Wolfgang
W
Hetzer
Roland
R
Felix
Roland
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D002114:Calcinosis / Q000000981:diagnostic imaging*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012986:Software Validation; D014057:Tomography, X-Ray Computed