title: Coronary artery calcium scoring: diagnostic accuracy of different software implementations.
abstract: 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.
authors: Department of Radiology, Charité, Campus Virchow-Klinikum, Humboldt-University, Berlin, Germany. Friedrich.Knollman@charite.de
authors: Friedrich D
authors: FD
authors: Knollmann
authors: Klaus
authors: K
authors: Helmig
authors: Susanne
authors: S
authors: Kapell
authors: Manfred
authors: M
authors: Hummel
authors: Wolfgang
authors: W
authors: Bocksch
authors: Roland
authors: R
authors: Hetzer
authors: Roland
authors: R
authors: Felix
mesh_terms: 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