title: Automatic determination of cardiovascular risk by CT attenuation correction maps in Rb-82 PET/CT.
abstract: We investigated fully automatic coronary artery calcium (CAC) scoring and cardiovascular disease (CVD) risk categorization from CT attenuation correction (CTAC) acquired at rest and stress during cardiac PET/CT and compared it with manual annotations in CTAC and with dedicated calcium scoring CT (CSCT).
  
  
  
  We included 133 consecutive patients undergoing myocardial perfusion82Rb PET/CT with the acquisition of low-dose CTAC at rest and stress. Additionally, a dedicated CSCT was performed for all patients. Manual CAC annotations in CTAC and CSCT provided the reference standard. In CTAC, CAC was scored automatically using a previously developed machine learning algorithm. Patients were assigned to a CVD risk category based on their Agatston score (0, 1-10, 11-100, 101-400, >400). Agreement in CVD risk categorization between manual and automatic scoring in CTAC at rest and stress resulted in Cohen's linearly weighted κ of 0.85 and 0.89, respectively. The agreement between CSCT and CTAC at rest resulted in κ of 0.82 and 0.74, using manual and automatic scoring, respectively. For CTAC at stress, these were 0.79 and 0.70, respectively.
  
  
  
  Automatic CAC scoring from CTAC PET/CT may allow routine CVD risk assessment from the CTAC component of PET/CT without any additional radiation dose or scan time.
authors.affiliation: Image Sciences Institute, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands. i.isgum@umcutrecht.nl.
authors.forename: Ivana
authors.initials: I
authors.lastname: Išgum
authors.affiliation: Image Sciences Institute, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
authors.forename: Bob D
authors.initials: BD
authors.lastname: de Vos
authors.affiliation: Image Sciences Institute, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
authors.forename: Jelmer M
authors.initials: JM
authors.lastname: Wolterink
authors.affiliation: Departments of Imaging and Medicine, Cedars-Sinai Medical Center, 8700 Beverly Blvd Ste. A047N, Los Angeles, CA, 90048, USA.
authors.forename: Damini
authors.initials: D
authors.lastname: Dey
authors.affiliation: Departments of Imaging and Medicine, Cedars-Sinai Medical Center, 8700 Beverly Blvd Ste. A047N, Los Angeles, CA, 90048, USA.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Berman
authors.affiliation: Departments of Imaging and Medicine, Cedars-Sinai Medical Center, 8700 Beverly Blvd Ste. A047N, Los Angeles, CA, 90048, USA.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Rubeaux
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
authors.forename: Tim
authors.initials: T
authors.lastname: Leiner
authors.affiliation: Departments of Imaging and Medicine, Cedars-Sinai Medical Center, 8700 Beverly Blvd Ste. A047N, Los Angeles, CA, 90048, USA.
authors.forename: Piotr J
authors.initials: PJ
authors.lastname: Slomka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002118:Calcium / Q000032:analysis; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D049268:Positron-Emission Tomography / Q000379:methods*; D012414:Rubidium Radioisotopes
chemical_list: D012414:Rubidium Radioisotopes; C000615479:Rubidium-82; D002118:Calcium
keywords: Automatic calcium scoring; CT attenuation correction map; cardiac CT; cardiovascular risk; coronary calcium