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DOI: 10.1148/radiol.2211001038
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(Radiology. 2001;221:213-221.)
© RSNA, 2001


Cardiac Imaging

Spiral versus Electron-Beam CT for Coronary Artery Calcium Scoring1

Jonathan G. Goldin, MD, PhD, Hyo-Chun Yoon, MD, PhD, Lloyd E. Greaser, III, MPH, Stefan B. Heinze, MD, Michael M. McNitt-Gray, PhD, Matthew S. Brown, PhD, James W. Sayre, PhD, Aletha M. Emerick, BS and Denise R. Aberle, MD

1 From the Departments of Radiological Sciences (J.G.G., S.B.H., M.S.B., A.M.E., D.R.A.), Radiology Physics (M.M.M.G.), and Biomathematics (J.W.S.), UCLA School of Medicine, 10833 Le Conte Ave, CHS B2-200, Los Angeles, CA 90095-1721; Department of Radiology, University of Utah School of Medicine, Salt Lake City (H.C.Y.); and Chicago Medical School, Ill (L.E.G.). Received June 5, 2000; revision requested July 26; final revision received March 30, 2001; accepted April 3. Address correspondence to J.G.G. (e-mail: jgoldin@mednet.ucla.edu).

PURPOSE: To determine differences in coronary artery calcium detection, quantification, and reproducibility, as measured at electron-beam computed tomography (CT) and subsecond spiral CT with retrospective electrocardiogram gating in an asymptomatic adult population.

MATERIALS AND METHODS: Seventy subjects asymptomatic for coronary heart disease underwent both electron-beam CT and subsecond spiral CT. In all subjects, two images each were obtained with both scanners. Two experienced readers using three different algorithms scored each of the four scans: one score for the electron-beam CT images and two scores for the spiral CT images.

RESULTS: With a 130-HU threshold for the quantification of calcium, there were no significant differences in interscan and interobserver variation in calcium scores between the electron-beam CT and spiral CT images. There was greater interobserver (P < .001) and interscan (P < .03) variation in scores when a 90-HU threshold was used for spiral CT images. With a 130-HU threshold, when calcium scores were used for clinical risk stratification, there was a significant difference between the results obtained with electron-beam CT and those obtained with spiral CT (P < .05).

CONCLUSION: Spiral CT has not yet proved to be a feasible alternative to electron-beam CT for coronary artery calcium quantification. There are systematic differences between calcium scores obtained with single-detector array subsecond spiral CT and those obtained with electron-beam CT.

Index terms: Calcium • Computed tomography (CT), electron beam, 54.12111, 54.12119 • Coronary vessels, CT, 54.12111, 54.12115, 54.12119 • Coronary vessels, stenosis or obstruction, 54.76, 54.812




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