Coronary calcium screening with dual-source CT: reliability of ungated, high-pitch chest CT in comparison with dedicated calcium-scoring CT.
OBJECTIVE
To investigate the reliability of ungated, high-pitch dual-source CT for coronary artery calcium (CAC) screening.


METHODS
One hundred and eighty-five smokers underwent a dual-source CT examination with acquisition of two sets of images during the same session: (a) ungated, high-pitch and high-temporal resolution acquisition over the entire thorax (i.e., chest CT); (b) prospectively ECG-triggered acquisition over the cardiac cavities (i.e., cardiac CT).


RESULTS
Sensitivity and specificity of chest CT for detecting positive CAC scores were 96.4 % and 100 %, respectively. There was excellent inter-technique agreement for determining the quantitative CAC score (ICC = 0.986). The mean difference between the two techniques was 11.27, representing 1.81 % of the average of the two techniques. The inter-technique agreement for categorizing patients into the four ranks of severity was excellent (weighted kappa = 0.95; 95 % CI 0.93-0.98). The inter-technique differences for quantitative CAC scores did not correlate with BMI (r = 0.05, p = 0.575) or heart rate (r = -0.06, p = 0.95); 87.2 % of them were explained by differences at the level of the right coronary artery (RCA: 0.8718; LAD: 0.1008; LCx: 0.0139; LM: 0.0136).


CONCLUSIONS
Ungated, high-pitch dual-source CT is a reliable imaging mode for CAC screening in the conditions of routine chest CT examinations.


CONCLUSIONS
• CAC is an independent risk factor for major cardiac events. • ECG-gated techniques are the reference standard for calcium scoring. • Great interest is directed toward calcium scoring on non-gated chest CT examinations. • Reliable calcium scoring can be obtained with dual-source CT in a high-pitch mode.
Department of Thoracic Imaging, Hospital Calmette (EA 2694), CHRU et Université de Lille, Lille, France.
Antoine
A
Hutt
Department of Biostatistics (EA 2694), CHRU et Université de Lille, Lille, France.
Alain
A
Duhamel
Department of Biostatistics (EA 2694), CHRU et Université de Lille, Lille, France.
Valérie
V
Deken
Department of Thoracic Imaging, Hospital Calmette (EA 2694), CHRU et Université de Lille, Lille, France.
Jean-Baptiste
JB
Faivre
Department of Radiology, Centre Hospitalier Général de Tourcoing, Tourcoing, France.
Francesco
F
Molinari
Department of Thoracic Imaging, Hospital Calmette (EA 2694), CHRU et Université de Lille, Lille, France.
Jacques
J
Remy
Department of Thoracic Imaging, Hospital Calmette (EA 2694), CHRU et Université de Lille, Lille, France. martine.remy@chru-lille.fr.
Martine
M
Remy-Jardin
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002114:Calcinosis / Q000000981:diagnostic imaging*; D055424:Cardiac-Gated Imaging Techniques / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
Calcium score; Dual-source CT; High pitch; Ungated-CT