Coronary risk assessment at X-ray dose equivalent ungated chest CT: Results of a multi-reader study

Michael Messerli; Lukas Hechelhammer; Sebastian Leschka; René Warschkow; Simon Wildermuth; Ralf W Bauer

doi:10.1016/j.clinimag.2017.10.014

Coronary risk assessment at X-ray dose equivalent ungated chest CT: Results of a multi-reader study

Clin Imaging. 2018 May-Jun:49:73-79. doi: 10.1016/j.clinimag.2017.10.014. Epub 2017 Oct 25.

Authors

Michael Messerli¹, Lukas Hechelhammer², Sebastian Leschka³, René Warschkow⁴, Simon Wildermuth², Ralf W Bauer²

Affiliations

¹ Division of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, Switzerland; Department of Nuclear Medicine, University Hospital Zurich, University Zurich, Switzerland. Electronic address: [email protected].
² Division of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, Switzerland.
³ Division of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, Switzerland; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University Zurich, Switzerland.
⁴ Department of Surgery, Cantonal Hospital St. Gallen, Switzerland.

PMID: 29149718
DOI: 10.1016/j.clinimag.2017.10.014

Abstract

Objectives: To determine the value of ultra-low dose chest CT with tin filtration for ordinal coronary artery calcium (CAC) risk scoring.

Methods: 50 patients were prospectively included and underwent clinical standard dose chest CT (1.8±0.7mSv) and ultra-low dose CT (0.13±0.01mSv). Four radiologists estimated presence and extent of CAC.

Results: Weighted kappa values for CAC were 0.76-0.97 in standard dose and 0.75-0.95 in ultra-low dose CT (p<0.001). Good to excellent agreement was observed for CAC ordinal risk assessment, with readers reporting identical risk in 81% of cases.

Conclusion: CAC risk can be qualitatively assessed from X-ray dose equivalent ungated chest CT.

Keywords: Computed tomography; Coronary artery calcium; Coronary artery disease; Iterative reconstruction; Tin filtration; Ultra-low dose.

MeSH terms

Adult
Aged
Aged, 80 and over
Calcinosis / diagnostic imaging*
Coronary Artery Disease / diagnostic imaging*
Female
Humans
Male
Middle Aged
Risk Assessment
Tomography, X-Ray Computed / methods
Young Adult