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Comprehensive Non-contrast CT Imaging of the Vulnerable Patient

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Asymptomatic Atherosclerosis

Part of the book series: Contemporary Cardiology ((CONCARD))

Abstract

Atherosclerotic cardiovascular disease is the leading cause of death in developed countries. Every year, one million people in the US experience a heart attack or sudden cardiac death. A large percentage of these patients have no prior symptoms of any kind but suffer from silent heart disease, which may cause a heart attack at any time. Currently, there is no reliable screening method to identify the “vulnerable patient” who may have silent heart disease and therefore is at the risk of suffering a cardiovascular event such as a heart attack.

Non-contrast cardiac CT is used worldwide to assess coronary artery calcium, a subclinical marker of coronary atherosclerosis. It has been recommended for screening asymptomatic individuals with intermediate-high Framingham risk, due to its high prognostic value, low radiation burden, and simplicity. In this chapter, we review technical aspects of imaging coronary calcium and techniques for “coronary calcium scoring” and review its value in prognostic studies.

The non-contrast cardiac CT scan provides three-dimensional images of the heart and contains important additional information regarding the patient’s cardiovascular risk, beyond the coronary calcium score. These include pericardial and thoracic fat, aortic calcification, aortic and left ventricular size, spotty calcification pattern, and the number of calcified lesions. These markers are, however, not considered in routine clinical analysis. In this chapter, we summarize the methods to quantify these markers of cardiovascular risk and the growing evidence regarding their clinical and prognostic significance. Automated algorithms to identify and quantify these markers may help in identifying the vulnerable patient with silent heart disease.

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References

  1. American Heart Association. Heart and Stroke Statistical Update. 2002.

    Google Scholar 

  2. Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: Part I: General considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation 2001;104:2746–2753.

    Article  PubMed  CAS  Google Scholar 

  3. Myerburg RJ, Interian A, Jr., Mitrani RM, Kessler KM, Castellanos A. Frequency of sudden cardiac death and profiles of risk. Am J Cardiol 1997;80:10F–19F.

    Article  PubMed  CAS  Google Scholar 

  4. Virmani R, Burke AP, Farb A. Sudden cardiac death. Cardiovasc Pathol 2001;10:211–218.

    Article  PubMed  CAS  Google Scholar 

  5. Naghavi M, Libby P, Falk E, et al. From vulnerable plaque to vulnerable patient: A call for new definitions and risk assessment strategies: Part I. Circulation 2003;108:1664–1672.

    Article  PubMed  Google Scholar 

  6. Naghavi M, Libby P, Falk E, et al. From vulnerable plaque to vulnerable patient: A call for new definitions and risk assessment strategies: Part II. Circulation 2003;108:1772–1778.

    Article  PubMed  Google Scholar 

  7. Grundy SM. Primary prevention of coronary heart disease: Integrating risk assessment with intervention. Circulation 1999;100:988–998.

    Article  PubMed  CAS  Google Scholar 

  8. Wilson PW, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation 1998;97:1837–1847.

    Article  PubMed  CAS  Google Scholar 

  9. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). Jama 2001;285:2486–2497.

    Article  Google Scholar 

  10. Ridker PM, Cushman M, Stampfer MJ, Tracy RP, Hennekens CH. Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med 1997;336:973–979.

    Article  PubMed  CAS  Google Scholar 

  11. Ridker PM, Hennekens CH, Buring JE, Rifai N. C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N Engl J Med 2000;342:836–843.

    Article  PubMed  CAS  Google Scholar 

  12. Ridker PM, Rifai N, Rose L, Buring JE, Cook NR. Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events. N Engl J Med 2002;347:1557–1565.

    Article  PubMed  CAS  Google Scholar 

  13. Pasceri V, Willerson JT, Yeh ET. Direct proinflammatory effect of C-reactive protein on human endothelial cells. Circulation 2000;102:2165–2168.

    Article  PubMed  CAS  Google Scholar 

  14. Arad Y, Goodman KJ, Roth M, Newstein D, Guerci AD. Coronary calcification, coronary disease risk factors, C-reactive protein, and atherosclerotic cardiovascular disease events: The St. Francis Heart Study. J Am Coll Cardiol 2005;46:158–165.

    Article  PubMed  CAS  Google Scholar 

  15. Shaw L, Raggi P, Schisterman E, Berman D, Callister T. Prognostic value of cardiac risk factors and coronary artery calcium screening for all-cause mortality. Radiology 2003;228:826–833.

    Article  PubMed  Google Scholar 

  16. Berman DS, Hachamovitch R, Shaw LJ, et al. Roles of nuclear cardiology, cardiac computed tomography, and cardiac magnetic resonance: Noninvasive risk stratification and a conceptual framework for the selection of noninvasive imaging tests in patients with known or suspected coronary artery disease. J Nucl Med 2006;47:1107–1118.

    PubMed  Google Scholar 

  17. Arad Y, Spadaro LA, Goodman K, Newstein D, Guerci AD. Prediction of coronary events with electron beam Computed Tomography. J Am Coll Cardiol 2000;36:1253–1260.

    Article  PubMed  CAS  Google Scholar 

  18. Raggi P, Callister TQ, Cooil B, et al. Identification of patients at increased risk of first unheralded acute myocardial infarction by electron-beam Computed Tomography. Circulation 2000;101:850–855.

    Article  PubMed  CAS  Google Scholar 

  19. Park R, Detrano R, Xiang M, et al. Combined use of Computed Tomography coronary calcium scores and C-reactive protein levels in predicting cardiovascular events in nondiabetic individuals. Circulation 2002;106:2073–2077.

    Article  PubMed  CAS  Google Scholar 

  20. Shemesh J, Morag-Koren N, Goldbourt U, et al. Coronary calcium by spiral computed tomography predicts cardiovascular events in high-risk hypertensive patients. J Hypertens 2004;22:605–610.

    Article  PubMed  CAS  Google Scholar 

  21. Wong ND, Hsu JC, Detrano RC, Diamond G, Eisenberg H, Gardin JM. Coronary artery calcium evaluation by electron beam Computed Tomography and its relation to new cardiovascular events. Am J Cardiol 2000;86:495–498.

    Article  PubMed  CAS  Google Scholar 

  22. Kondos GT, Hoff JA, Sevrukov A, et al. Electron-beam tomography coronary artery calcium and cardiac events: A 37-month follow-up of 5635 initially asymptomatic low- to intermediate-risk adults. Circulation 2003;107:2571–2576.

    Article  PubMed  Google Scholar 

  23. Greenland P, LaBree L, Azen SP, Doherty TM, Detrano RC. Coronary artery calcium score combined with Framingham score for risk prediction in asymptomatic individuals. J Am Med Assoc 2004;291:210–215.

    Article  CAS  Google Scholar 

  24. LaMonte MJ, FitzGerald SJ, Church TS, et al. Coronary artery calcium score and coronary heart disease events in a large cohort of asymptomatic men and women. Am J Epidemiol 2005;162:421–429.

    Article  PubMed  Google Scholar 

  25. Taylor AJ, Bindeman J, Feuerstein I, Cao F, Brazaitis M, O’Malley PG. Coronary calcium independently predicts incident premature coronary heart disease over measured cardiovascular risk factors: mean three-year outcomes in the Prospective Army Coronary Calcium (PACC) project. J Am Coll Cardiol 2005;46:807–814.

    Article  PubMed  CAS  Google Scholar 

  26. Vliegenthart R, Oudkerk M, Hofman A, et al. Coronary calcification improves cardiovascular risk prediction in the elderly. Circulation 2005;112:572–577.

    Article  PubMed  Google Scholar 

  27. Becker A, Knez A, Becker C, et al. Prediction of serious cardiovascular events by determining coronary artery calcification measured by multi-slice computed tomography. Dtsch Med Wochenschr 2005;130:2433–2438.

    Article  PubMed  CAS  Google Scholar 

  28. Detrano R, Guerci AD, Carr JJ, et al. Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med 2008;358:1336–1345.

    Article  PubMed  CAS  Google Scholar 

  29. Budoff MJ, Shaw LJ, Liu ST, et al. Long-term prognosis associated with coronary calcification: Observations from a registry of 25,253 patients. J Am Coll Cardiol 2007;49:1860–1870.

    Article  PubMed  Google Scholar 

  30. Budoff MJ, Gul KM. Expert review on coronary calcium. Vasc Health Risk Manag 2008;4:315–324.

    PubMed  Google Scholar 

  31. Budoff MJ, Achenbach S, Blumenthal RS, et al. Assessment of coronary artery disease by cardiac computed tomography: A scientific statement from the American Heart Association Committee on Cardiovascular Imaging and Intervention, Council on Cardiovascular Radiology and Intervention, and Committee on Cardiac Imaging, Council on Clinical Cardiology. Circulation 2006;114:1761–1791.

    Article  PubMed  Google Scholar 

  32. O’Rourke RA, Brundage BH, Froelicher VF, et al. American College of Cardiology/American Heart Association expert consensus document on electron-beam Computed Tomography for the diagnosis and prognosis of coronary artery disease. J Am Coll Cardiol 2000;36:326–340.

    Article  PubMed  Google Scholar 

  33. Mao S, Lu B, Oudiz RJ, Bakhsheshi H, Liu SC, Budoff MJ. Coronary artery motion in electron beam tomography. J Comput Assist Tomogr 2000;24:253–258.

    Article  PubMed  CAS  Google Scholar 

  34. Mao S, Bakhsheshi H, Lu B, Liu SC, Oudiz RJ, Budoff MJ. Effect of electrocardiogram triggering on reproducibility of coronary artery calcium scoring. Radiology 2001;220:707–711.

    Article  PubMed  CAS  Google Scholar 

  35. Knez A, Becker C, Becker A, et al. Determination of coronary calcium with multi-slice spiral Computed Tomography: A comparative study with electron-beam CT. Int J Cardiovasc Imaging 2002;18:295–303.

    Article  PubMed  Google Scholar 

  36. Daniell AL, Wong ND, Friedman JD, et al. Concordance of coronary artery calcium estimates between MDCT and electron beam tomography. AJR Am J Roentgenol 2005;185:1542–1545.

    Article  PubMed  Google Scholar 

  37. Stanford W, Thompson BH, Burns TL, Heery SD, Burr MC. Coronary artery calcium quantification at multi-detector row helical CT versus electron-beam CT. Radiology 2004;230:397–402.

    Article  PubMed  Google Scholar 

  38. Carr JJ, Crouse JR, 3rd, Goff DC, Jr., D’Agostino RB, Jr., Peterson NP, Burke GL. Evaluation of subsecond gated helical CT for quantification of coronary artery calcium and comparison with electron beam CT. AJR Am J Roentgenol 2000;174:915–921.

    Article  PubMed  CAS  Google Scholar 

  39. Ohnesorge B, Flohr T, Fischbach R, et al. Reproducibility of coronary calcium quantification in repeat examinations with retrospectively ECG-gated multisection spiral CT. Eur Radiol 2002;12:1532–1540.

    Article  PubMed  CAS  Google Scholar 

  40. Becker CR, Kleffel T, Crispin A, et al. Coronary artery calcium measurement: Agreement of multirow detector and electron beam CT. AJR Am J Roentgenol 2001;176:1295–1298.

    Article  PubMed  CAS  Google Scholar 

  41. Hunold P, Vogt F, Schmermund A, et al. Radiation exposure during cardiac CT: Effective doses at multi-detector row CT and electron-beam CT. Radiology 2003;226:145–152.

    Article  PubMed  Google Scholar 

  42. Morin RL, Gerber TC, McCollough CH. Radiation dose in computed tomography of the heart. Circulation 2003;107:917–922.

    Article  PubMed  Google Scholar 

  43. Flohr T, Schoepf U, Kuettner A, et al. Advances in cardiac imaging with 16-section CT systems. Acad Radiol 2003;10:386–401.

    Article  PubMed  Google Scholar 

  44. Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M, Jr., Detrano R. Quantification of coronary artery calcium using ultrafast Computed Tomography. J Am Coll Cardiol 1990;15:827–832.

    Article  PubMed  CAS  Google Scholar 

  45. Callister T, Cooil B, Raya S, Lippolis N, Russo D, Raggi P. Coronary artery disease: Improved reproducibility of calcium scoring with an electron-beam CT volumetric method. Radiology 1998;208:807–814.

    PubMed  CAS  Google Scholar 

  46. McCollough CH, Ulzheimer S, Halliburton SS, Shanneik K, White RD, Kalender WA. Coronary artery calcium: A multi-institutional, multimanufacturer international standard for quantification at cardiac CT. Radiology 2007;243:527–538.

    Article  PubMed  Google Scholar 

  47. Rumberger JA, Kaufman L. A Rosetta Stone for Coronary Calcium Risk Stratification: Agatston, Volume, and Mass Scores in 11,490 Individuals. Am J Roentgentol 2003;181:743–748.

    Article  Google Scholar 

  48. Hong C, Bae KT, Pilgram TK. Coronary artery calcium: accuracy and reproducibility of measurements with multi-detector row CT–assessment of effects of different thresholds and quantification methods. Radiology 2003;227:795–801.

    Article  PubMed  Google Scholar 

  49. Van Hoe LR, De Meerleer KG, Leyman PP, Vanhoenacker PK. Coronary artery calcium scoring using ECG-gated multidetector CT: Effect of individually optimized image-reconstruction windows on image quality and measurement reproducibility. AJR Am J Roentgenol 2003;181:1093–1100.

    Article  PubMed  Google Scholar 

  50. Takahashi N, Bae KT. Quantification of coronary artery calcium with multi-detector row CT: Assessing interscan variability with different tube currents pilot study. Radiology 2003;228:101–106.

    Article  PubMed  Google Scholar 

  51. Detrano RC, Anderson M, Nelson J, et al. Coronary calcium measurements: Effect of CT scanner type and calcium measure on rescan reproducibility–MESA study. Radiology 2005;236:477–484.

    Article  PubMed  Google Scholar 

  52. Sevrukov AB, Bland JM, Kondos GT. Serial electron beam CT measurements of coronary artery calcium: Has your patient’s calcium score actually changed? AJR Am J Roentgenol 2005;185:1546–1553.

    Article  PubMed  Google Scholar 

  53. Chung H, McClelland RL, Katz R, Carr JJ, Budoff MJ. Repeatability limits for measurement of coronary artery calcified plaque with cardiac CT in The Multi-Ethnic Study of Atherosclerosis. AJR Am J Roentgenol 2008;190:W87–W92.

    Article  PubMed  Google Scholar 

  54. Folsom AR, Kronmal RA, Detrano RC, et al. Coronary artery calcification compared with carotid intima-media thickness in the prediction of cardiovascular disease incidence: The Multi-Ethnic Study of Atherosclerosis (MESA). Arch Intern Med 2008;168:1333–1339.

    Article  PubMed  Google Scholar 

  55. Becker A, Leber A, Becker C, Knez A. Predictive value of coronary calcifications for future cardiac events in asymptomatic individuals. Am Heart J 2008;155:154–160.

    Article  PubMed  Google Scholar 

  56. Bild DE, Bluemke DA, Burke GL, et al. Multi-Ethnic Study of Atherosclerosis: Objectives and design. Am J Epidemiol 2002;156:871–881.

    Article  PubMed  Google Scholar 

  57. Schmermund A, Mohlenkamp S, Stang A, et al. Assessment of clinically silent atherosclerotic disease and established and novel risk factors for predicting myocardial infarction and cardiac death in healthy middle-aged subjects: Rationale and design of the Heinz Nixdorf RECALL study. Risk factors, evaluation of coronary calcium and lifestyle. Am Heart J 2002;144:212–218.

    Article  PubMed  Google Scholar 

  58. Dey D, Callister TQ, Slomka PJ, Aboul-Enein F, Nishina H, Kang X, Gransar H, Wong ND, Miranda-Peats R, Hayes S, Friedman JD, Berman DS. Computer-aided detection and evaluation of lipid-rich plaque in non-contrast cardiac Computed Tomography. Am J Roentgenol 2006;186:S407–S413.

    Article  Google Scholar 

  59. Teichholz LE, Petrillo S, Larson AJ, Klig V. Quantitative assessment of atherosclerosis by electron beam tomography. Am J Cardiol 2002;90:1416–1419.

    Article  PubMed  Google Scholar 

  60. Rosito GA, Massaro JM, Hoffmann U, et al. Pericardial fat, visceral abdominal fat, cardiovascular disease risk factors, and vascular calcification in a community-based sample: The Framingham Heart Study. Circulation 2008;117:605–613.

    Article  PubMed  Google Scholar 

  61. Gorter PM, van Lindert ASR, de Vos AM, et al. Quantification of epicardial and peri-coronary fat using cardiac Computed Tomography; reproducibility and relation with obesity and metabolic syndrome in patients suspected of coronary artery disease. Atherosclerosis 2008;197:896–903.

    Article  PubMed  CAS  Google Scholar 

  62. Ding J, Kritchevsky SB, Harris TB, et al. The association of pericardial fat with calcified coronary plaque. Obesity 2008;16:1914–1919.

    Article  PubMed  Google Scholar 

  63. Taguchi R, Takasu J, Itani Y, et al. Pericardial fat accumulation in men as a risk factor for coronary artery disease. Atherosclerosis 2001;157:203–209.

    Article  PubMed  CAS  Google Scholar 

  64. Wheeler GL, Shi R, Beck SR, et al. Pericardial and visceral adipose tissues measured volumetrically with Computed Tomography are highly associated in type 2 diabetic families. Invest Radiol 2005;40:97–101.

    Article  PubMed  Google Scholar 

  65. Dey D, Suzuki Y, Suzuki S, et al. Automated quantitation of pericardiac fat from noncontrast CT. Invest Radiol 2008;43:145–153.

    Article  PubMed  Google Scholar 

  66. Mahabadi AA, Massaro JM, Rosito GA, et al. Association of pericardial fat, intrathoracic fat, and visceral abdominal fat with cardiovascular disease burden: The Framingham Heart Study. Eur Heart J 2009;30(7):850–856.

    Article  PubMed  Google Scholar 

  67. Greif M, Becker A, von Ziegler F, Lebherz C, Lehrke M, Brödl U, Tittus J, Parhofer K, Becker C, Reiser M, Knez A, Leber AW. Pericardial adipose tissue determined by dual source CT is a risk factor for coronary atherosclerosis. Arterioscler Thromb Vasc Biol 2009;29(5):781–786.

    Article  PubMed  CAS  Google Scholar 

  68. Bandekar A, Naghavi M, Kakadiaris IA. Automated pericardial fat quantification in CT data. In: Proc. of the 28th Annual Intl. Conf. of the IEEE Engineering in Medical and Biology Society, (EMBS’06), New York, Aug 30 – Sep 3, 2006.

    Google Scholar 

  69. Dey D, Wong ND, Tamarappoo BK, Nakazato R, Shah A, Gransar H, Cheng VY, Ramesh A, Kakadiaris I, Germano G, Slomka PJ, Berman DS. Computer-aided non-contrast CT-based quantification of pericardial and thoracic fat and their associations with coronary calcium and metabolic syndrome. Atherosclerosis 2009: in press: doi:10.1016/j.atherosclerosis.2009.08.032.

    Google Scholar 

  70. Takasu J, Takanashi K, Naito S, et al. Evaluation of morphological changes of the atherosclerotic aorta by enhanced Computed Tomography. Atherosclerosis 1992;97:107–121.

    Article  PubMed  CAS  Google Scholar 

  71. Itani Y, Watanabe S, Masuda Y. Aortic calcification detected in a mass chest screening program using a mobile helical computed tomography unit. Relationship to risk factors and coronary artery disease. Circ J 2004;68:538–541.

    Article  PubMed  Google Scholar 

  72. Atak R, Ileri M, Yetkin O, et al. The role of valvular and thoracic aortic calcifications in distinction between ischemic and nonischemic cardiomyopathy. Angiology 2004;55:661–667.

    PubMed  Google Scholar 

  73. Adler Y, Fisman EZ, Shemesh J, et al. Spiral computed tomography evidence of close correlation between coronary and thoracic aorta calcifications. Atherosclerosis 2004;176:133–138.

    Article  PubMed  CAS  Google Scholar 

  74. Tanne D, Tenenbaum A, Shemesh J, et al. Calcification of the thoracic aorta by spiral Computed Tomography among hypertensive patients: Associations and risk of ischemic cerebrovascular events. Int J Cardiol 2007;120:32–37.

    Article  PubMed  Google Scholar 

  75. Iribarren C, Sidney S, Sternfeld B, Browner WS. Calcification of the aortic arch: Risk factors and association with coronary heart disease, stroke, and peripheral vascular disease. J Am Med Assoc 2000;283:2810–2815.

    Article  CAS  Google Scholar 

  76. Wolak A, Gransar H, Thomson LEJ, et al. Aortic size assessment by noncontrast cardiac Computed Tomography: Normal limits by age, gender, and body surface area. J Am Coll Cardiol Img 2008;1:200–209.

    Google Scholar 

  77. Mao SS, Ahmadi N, Shah B, et al. Normal thoracic aorta diameter on cardiac Computed Tomography in healthy asymptomatic adults impact of age and gender. Acad Radiol 2008;15:827–834.

    Article  PubMed  Google Scholar 

  78. Kurkure U, Avila-Montes OC, Kakadiaris IA. Automated localization and segmentation of thoracic aorta in non-contrast CT images. In: Proc. 5th IEEE International Symposium on Biomedical Imaging: From Nano to Macro. Paris, France, 2008.

    Google Scholar 

  79. Chikos PM, Figley MM, Fisher L. Correlation between chest film and angiographic assessment of left ventricular size. AJR Am J Roentgenol 1977;128:367–373.

    Article  PubMed  CAS  Google Scholar 

  80. Frishman WH, Nadelmann J, Ooi WL, et al. Cardiomegaly on chest X-ray: Prognostic implications from a ten-year cohort study of elderly subjects: a report from the Bronx Longitudinal Aging Study. Am Heart J 1992;124:1026–1030.

    Article  PubMed  CAS  Google Scholar 

  81. Sandvik L, Erikssen J, Thaulow E, Erikssen G, Mundal R, Aakhus T. Heart volume and cardiovascular mortality. A 16 year follow-up study of 1984 healthy middle-aged men. Eur Heart J 1993;14:592–596.

    Article  PubMed  CAS  Google Scholar 

  82. Nasir K, Katz R, Mao S, Takasu J, Bomma C, Lima J, Bluemke D, Kronmal R, Carr J, Budoff M. Comparison of left ventricular size by Computed Tomography with Magnetic Resonance Imaging measures of left ventricle mass and volumes: The Multi-Ethnic Study of Atherosclerosis. J Cardiovasc Comput Tomogr 2008;2:141–148.

    Article  PubMed  Google Scholar 

  83. Ehara S, Kobayashi Y, Yoshiyama M, et al. Spotty calcification typifies the culprit plaque in patients with acute myocardial infarction: An intravascular ultrasound study. Circulation 2004;110:3424–3429.

    Article  PubMed  Google Scholar 

  84. van der Hoeven BL, Liem SS, Oemrawsingh PV, et al. Role of calcified spots detected by intravascular ultrasound in patients with ST-segment elevation acute myocardial infarction. Am J Cardiol 2006;98:309–313.

    Article  PubMed  Google Scholar 

  85. Motoyama S, Kondo T, Sarai M, et al. Multislice Computed Tomographic characteristics of coronary lesions in acute coronary syndromes. J Am Coll Cardiol 2007;50:319–326.

    Article  PubMed  Google Scholar 

  86. Williams M, Shaw LJ, Raggi P, et al. Prognostic value of number and site of calcified coronary lesions compared with the total score. J Am Coll Cardiol Cardiovasc Imaging 2008;1:61–69.

    Article  Google Scholar 

  87. Kurkure U, Chittajallu, D, Brunner, G, Yalamanchili, R, Kakadiaris IA. Detection of coronary calcifications using supervised hierarchical classification. In: Proc. 2nd MICCAI Workshop on Computer Vision for Intravascular and Intracardiac Imaging. New York, NY, 2008.

    Google Scholar 

  88. Brunner G, Chittajallu DR, Kurkure U, Kakadiaris IA. A heart-centered coordinate system for the detection of coronary artery zones in non-contrast Computed Tomography data. In: Proc. 2nd MICCAI Workshop on Computer Vision for Intravascular and Intracardiac Imaging. New York, NY, 2008.

    Google Scholar 

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Authors and Affiliations

  1. Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, USA

    Damini Dey

  2. Department of Engineering, University of Houston, Houston, TX, USA

    Ioannis A. Kakadiaris

  3. BioMed CT Reading Center, Harbor-UCLA Medical Center, Torrance, CA, USA

    Matthew J. Budoff

  4. Society for Heart Attack Prevention and Eradication (SHAPE), 710 North Post Oak, Suite 400, Houston, 77024, Texas, USA

    Morteza Naghavi

  5. Department of Cardiac Imaging and Nuclear Cardiology, Cedars-Sinai Medical School, Los Angeles, CA, USA

    Daniel S. Berman

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  1. Damini Dey
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  2. Ioannis A. Kakadiaris
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  3. Matthew J. Budoff
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  4. Morteza Naghavi
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  1. Endothelix, Inc., El Rio 8275, Houston, 77054, USA

    Morteza Naghavi

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Dey, D., Kakadiaris, I.A., Budoff, M.J., Naghavi, M., Berman, D.S. (2011). Comprehensive Non-contrast CT Imaging of the Vulnerable Patient. In: Naghavi, M. (eds) Asymptomatic Atherosclerosis. Contemporary Cardiology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-179-0_28

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