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Cardiac Imaging |
1 From Dept of Radiology, State University Groningen, University Hospital Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands (R.V., M.O.); Depts of Epidemiology and Biostatistics (R.V., A.H., J.C.M.W.) and Radiology, Daniel den Hoed Clinic, Erasmus Medical Center (M.O.), Rotterdam, the Netherlands; and Dept of Radiology, First University Hospital, Chengdu, P.R. China (B.S.). Received Oct 10, 2002; revision requested Dec 19; revision received Feb 11, 2003; accepted March 13. Supported in part by the NESTOR program for geriatric research, Netherlands Heart Foundation, Netherlands Organization for Scientific Research, Health Research and Development Council grants 28–2975 and 97–1-364, and Municipality of Rotterdam. Address correspondence to R.V. (e-mail: r.vliegenthart@rad.azg.nl).
PURPOSE: To compare the accuracy of electron-beam computed tomography (CT) with 3.0- and 1.5-mm section thickness for calcium quantification and the prevalence of coronary calcifications with each.
MATERIALS AND METHODS: Electron-beam CT images were acquired with nonoverlapping 1.5- and 3.0-mm section thickness. Scans were obtained in an anthropomorphic thorax phantom with calcium cylinders of different sizes and densities, as well as in 1,302 study participants. A calcified lesion was defined as a minimum of 2 pixels (area, 0.52 mm2) with a minimum attenuation of 130 HU. The calcified lesions were quantified by means of a volumetric method with isotropic interpolation. From the phantom scans, mean volume scores, SDs, and measurement variations were calculated. From the participant scans, median volume scores and interquartile ranges were calculated. Participants were classified in categories based on cutoff levels for volume score quartiles for the 1.5-mm scans. An intraclass correlation coefficient (
value) was calculated as a measure of correlation between categories.
RESULTS: In the phantom, deviations of calculated volumes from the true cylinder volumes and measurement variations were generally higher for the 3.0-mm protocol than for the 1.5-mm protocol. In the participants, the median volume score was 100 mm3 (interquartile range, 11–409 mm3) for the 3.0-mm protocol and 144 mm3 (interquartile range, 35–513 mm3) for the 1.5-mm protocol. Agreement between classifications of volume scores for the 1.5- and 3.0-mm scans was good ( = 0.62, P < .001). Compared with the quartile classification for the 1.5-mm scan, however, classifications for 370 (28%) participants were put in a different category with the 3.0-mm protocol.
CONCLUSION: In a phantom, electron-beam CT scans with 3.0-mm section thickness yield less accurate estimates of calcified volume than do 1.5-mm scans. Electron-beam CT protocols with thinner sections considerably affect classification of individuals on the basis of the amount of coronary calcification depicted.
© RSNA, 2003
Index terms: Coronary vessels, calcification, 54.81 • Coronary vessels, CT, 54.12118
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