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Coronary calcium screening with dual-source CT: reliability of ungated, high-pitch chest CT in comparison with dedicated calcium-scoring CT

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Abstract

Purpose

To investigate the reliability of ungated, high-pitch dual-source CT for coronary artery calcium (CAC) screening.

Materials and 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).

Conclusion

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

Key points

• 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.

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Acknowledgements

The scientific guarantor of this publication is Pr Martine REMY-JARDIN. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: prospective, observational, performed at one institution.

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Authors and Affiliations

  1. Department of Thoracic Imaging, Hospital Calmette (EA 2694), CHRU et Université de Lille, Lille, France

    Antoine Hutt, Jean-Baptiste Faivre, Jacques Remy & Martine Remy-Jardin

  2. Department of Biostatistics (EA 2694), CHRU et Université de Lille, Lille, France

    Alain Duhamel & Valérie Deken

  3. Department of Radiology, Centre Hospitalier Général de Tourcoing, Tourcoing, France

    Francesco Molinari

Authors
  1. Antoine Hutt
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  2. Alain Duhamel
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  3. Valérie Deken
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  4. Jean-Baptiste Faivre
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  5. Francesco Molinari
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  6. Jacques Remy
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  7. Martine Remy-Jardin
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Correspondence to Martine Remy-Jardin.

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Hutt, A., Duhamel, A., Deken, V. et al. Coronary calcium screening with dual-source CT: reliability of ungated, high-pitch chest CT in comparison with dedicated calcium-scoring CT. Eur Radiol 26, 1521–1528 (2016). https://doi.org/10.1007/s00330-015-3978-7

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  • DOI: https://doi.org/10.1007/s00330-015-3978-7

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