title: Impact of Advanced Modeled Iterative Reconstruction on Coronary Artery Calcium Quantification.
abstract: To evaluate the influence of advanced modeled iterative reconstruction (ADMIRE) on the coronary artery calcium (CAC) scores by computed tomography (CT).
  
  
  
  Sixty patients underwent CAC imaging with dual-source 192-slice CT. Agatston, volume and mass score were calculated from filtered back projection (FBP) and iterative reconstructions with different levels of ADMIRE. Friedman test and Wilcoxon rank sum test were used for multiple comparisons of CAC values and the difference ratio among different ADMIRE groups using FBP as reference.
  
  
  
  The median Agatston score (range) using FBP was 115 (0.1-3047) and significantly decreased with incremental ADMIRE levels 1-5: 96 (0.1-2813), 91 (0-2764), 87 (0-2699), 80 (0-2590), 70 (0-2440); all P < 0.001. In comparison with FBP Agatston, volume and mass scores significantly decreased with increasing ADMIRE levels 1-5 (P < 0.001): from -12% to -39%, from -14% to -41%, and from -13% to -40%, respectively. In four patients with low calcium burden, the use of ADMIRE 2 or higher resulted in the disappearance of calcium that was detectable using FBP or ADMIRE 1. The decrease of CAC in high-level ADMIRE resulted in a reassignment to a lower Agatston risk group in 27%.
  
  
  
  ADMIRE causes a substantial reduction of the CAC scores measured by cardiac CT, which leads to an underestimation of cardiovascular risk scores in some patients.
authors.affiliation: Division of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, Rorschacherstrasse 95, 9007 St. Gallen, Switzerland. Electronic address: Michael.Messerli@kssg.ch.
authors.forename: Michael
authors.initials: M
authors.lastname: Messerli
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Germany.
authors.forename: Fabian
authors.initials: F
authors.lastname: Rengier
authors.affiliation: Division of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, Rorschacherstrasse 95, 9007 St. Gallen, Switzerland.
authors.forename: Lotus
authors.initials: L
authors.lastname: Desbiolles
authors.affiliation: Department of Cardiology, Cantonal Hospital St. Gallen, Switzerland.
authors.forename: Niklas F
authors.initials: NF
authors.lastname: Ehl
authors.affiliation: Division of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, Rorschacherstrasse 95, 9007 St. Gallen, Switzerland.
authors.forename: Ralf W
authors.initials: RW
authors.lastname: Bauer
authors.affiliation: Division of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, Rorschacherstrasse 95, 9007 St. Gallen, Switzerland; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University Zurich, Switzerland.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Leschka
authors.affiliation: Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University Zurich, Switzerland.
authors.forename: Hatem
authors.initials: H
authors.lastname: Alkadhi
authors.affiliation: Division of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, Rorschacherstrasse 95, 9007 St. Gallen, Switzerland.
authors.forename: Simon
authors.initials: S
authors.lastname: Wildermuth
authors.affiliation: Division of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, Rorschacherstrasse 95, 9007 St. Gallen, Switzerland.
authors.forename: Claas P
authors.initials: CP
authors.lastname: Nähle
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D061205:Vascular Calcification / Q000000981:diagnostic imaging*
keywords: Agatston score; advanced modeled iterative reconstruction; computed tomography; coronary artery calcium; coronary artery disease; iterative reconstruction