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Automatic detection and quantification of the Agatston coronary artery calcium score on contrast computed tomography angiography

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Abstract

Potentially, Agatston coronary artery calcium (CAC) score could be calculated on contrast computed tomography coronary angiography (CTA). This will make a separate non-contrast CT scan superfluous. This study aims to assess the performance of a novel fully automatic algorithm to detect and quantify the Agatston CAC score in contrast CTA images. From a clinical registry, 20 patients were randomly selected for each CAC category (i.e. 0, 1–99, 100–399, 400–999, ≥1,000). The Agatston CAC score on non-contrast CT was calculated manually, while the novel algorithm was used to automatically detect and quantify Agatston CAC score in contrast CTA images. The resulting Agatston CAC scores were validated against the non-contrast images. A total of 100 patients (60 ± 11 years, 63 men) were included. The median CAC score on non-contrast CT was 145 (IQR 5–760), whereas the contrast CTA CAC score was 170 (IQR 23–594) (P = 0.004). The automatically computed CAC score showed a high correlation (R = 0.949; P < 0.001) and intra-class correlation (R = 0.863; P < 0.001) with non-contrast CT CAC score. Moreover, agreement within CAC categories was good (κ 0.588). Fully automatic detection of Agatston CAC score on contrast CTA is feasible and showed high correlation with non-contrast CT CAC score. This could imply a radiation dose reduction and time saving by omitting the non-contrast scan.

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Acknowledgments

We thank A. Rares for his contribution to the preliminary experiments regarding this algorithm.

Conflict of interest

Michiel A. de Graaf is supported by a research grant from the Interuniversity Cardiology Institute of the Netherlands (ICIN, Utrecht, The Netherlands). The department of Cardiology received research grants from Biotronik, Medtronic, Boston Scientific Corporation, St Jude Medical, Lantheus Medical Imaging and GE Healthcare. This work was supported by Dutch Technology Foundation STW, Utrecht, the Netherlands, grant 10084. Pieter Kitslaar is employed by Medis medical imaging systems bv and has a research appointment at the Leiden University Medical Center. Hans Reiber is the Chief Executive Officer of Medis medical imaging systems bv and a Professor of Medical Imaging at the Leiden University Medical Center.

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Authors and Affiliations

  1. Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, Postal zone 2300 RC, 2333 ZA, Leiden, The Netherlands

    Wehab Ahmed, Michiel A. de Graaf, Jeroen J. Bax & Arthur J. Scholte

  2. The Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands

    Michiel A. de Graaf

  3. Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands

    Alexander Broersen, Pieter H. Kitslaar, Elco Oost, Jouke Dijkstra & Johan H. C. Reiber

  4. Medis Medical Imaging Systems bv, Leiden, The Netherlands

    Pieter H. Kitslaar & Johan H. C. Reiber

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  1. Wehab Ahmed
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Correspondence to Arthur J. Scholte.

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W. Ahmed and M. A. de Graaf share first authorship.

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Ahmed, W., de Graaf, M.A., Broersen, A. et al. Automatic detection and quantification of the Agatston coronary artery calcium score on contrast computed tomography angiography. Int J Cardiovasc Imaging 31, 151–161 (2015). https://doi.org/10.1007/s10554-014-0519-4

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