title: The predictive value of computed tomography calcium scores: a comparison with quantitative volumetric intravascular ultrasound.
abstract: OBJECTIVE
  To evaluate the relationship between coronary artery calcium scoring (CACS) and intravascular ultrasound (IVUS) calcification and disease severity.
  
  
  METHODS
  Forty-five angina patients who underwent CACS 18+/-23 days before IVUS were studied. The CACS was recorded for each lesion matched to a specific IVUS lesion. Cross-sectional area measurements of the external elastic membrane, lumen area, plaque and media, and plaque burden were performed. The arc and length of calcification were measured.
  
  
  RESULTS
  There were 106 calcified lesions detected by IVUS. Eighty-five of those lesions (80%) were detected by CACS, but 21 calcified lesions (20%) were missed. Fourteen (50%) out of 28 of the lesions with an IVUS-calcium arc below the 25th percentile (51.4 degrees ) were detected by CACS vs. 91% of lesions with an IVUS-calcium arc >51.4 degrees (P<.05). Similarly, 21 (58%) of 36 lesions <or=3 mm in length were detected vs. 91% of lesions >3 mm (P<.05). We divided IVUS-calcified lesions into CACS <or=10 and >10. Mean plaque burden, calcified length, and arc of calcium increased significantly, while minimum lumen area decreased with increasing CACS. There was the same tendency in culprit and nonculprit calcified lesions, respectively. Multivariate analysis showed a calcified length (regression coefficient=8.718, 95% CI 4.668-12.77, P<.001) and an arc of calcium (regression coefficient=2.789, 95% CI 1.419-4.119, P<.001) were significant predictors for CACS.
  
  
  CONCLUSIONS
  This study suggests that a CACS could evaluate coronary calcium burden noninvasively through the accurate estimation of calcium-arc and length.
authors.affiliation: Cardiovascular Research Institute, Washington Hospital Center, Washington, DC 20010, USA.
authors.forename: Teruo
authors.initials: T
authors.lastname: Okabe
authors.forename: Gary S
authors.initials: GS
authors.lastname: Mintz
authors.forename: Wm Guy
authors.initials: WG
authors.lastname: Weigold
authors.forename: Robert
authors.initials: R
authors.lastname: Roswell
authors.forename: Subodh
authors.initials: S
authors.lastname: Joshi
authors.forename: Sung Yun
authors.initials: SY
authors.lastname: Lee
authors.forename: Bongryeol
authors.initials: B
authors.lastname: Lee
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Steinberg
authors.forename: Probal
authors.initials: P
authors.lastname: Roy
authors.forename: Tina L Pinto
authors.initials: TL
authors.lastname: Slottow
authors.forename: Kimberly
authors.initials: K
authors.lastname: Kaneshige
authors.forename: Rebecca
authors.initials: R
authors.lastname: Torguson
authors.forename: Zhenyi
authors.initials: Z
authors.lastname: Xue
authors.forename: Lowell F
authors.initials: LF
authors.lastname: Satler
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Kent
authors.forename: Augusto D
authors.initials: AD
authors.lastname: Pichard
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Weissman
authors.forename: Joseph
authors.initials: J
authors.lastname: Lindsay
authors.forename: Ron
authors.initials: R
authors.lastname: Waksman
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000209:etiology*; D002114:Calcinosis / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012042:Registries; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional