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Background: Obtaining coronary calcium score (CAC) from coronary CTA (CAC-CTA) can reduce radiation, shorten studies and reduce cost. Practical methods, using commercial software are needed to make CAC-CTA clinically relevant.
Methods: We evaluated 50 clinical coronary CTA studies (Toshiba Vision scanner). CAC ranged from 0-1510 Agatson units with 175 individual plaques. Using Vital Images, Vitrea advanced module, we compared standard manual noncontrast CAC to manual calcific plaque segmentation on original axial 0.6 mm thick contrast CTA images, measuring blood signal on each image. CAC and CAC-CTA per plaque and per patient were compared and differences compared to blood signal (SAS).
Results: Regression and ICC values were both 0.97(p< 0.0001) for total CAC(Figure) vs CAC-CTA and per plaque values (Per plaque CAC=1.1330 CAC-CTA + 7.19, SE 0.0427, Limits 1.0492-1.2168, p<0.0001. Scatter increased at CAC>400, but CAC>400 detection(36% of cases) from regression corrected CAC-CTA showed a positive predictive value 0.88, negative predictive value 0.91, accuracy 0.91. Blood signal showed no relationship to per plaque or total differences between CAC and CAC-CTA.
Conclusions: CAC-CTA using clinical imaging and post-processing shows promise. Further large scale multicenter, multi-vendor studies are needed.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Non Invasive Imaging: Coronary Calcium Scoring and CV Risk Assessment
Abstract Category: 27. Non Invasive Imaging: CT/Multimodality, Angiography, and Non-CT Angiography
Presentation Number: 1198-240
- 2017 American College of Cardiology Foundation