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Influence of Body Size and Section Level on Calcium Phantom Measurements at Coronary Artery Calcium CT Scanning¹

¹ From the Colleges of Medicine (W.S., T.L.B., B.H.T., R.M.L., L.T.M.) and Public Health (T.L.B., J.D.W., R.M.L., L.T.M.), University of Iowa, 200 Hawkins Dr, 3896 JPP, Iowa City, IA 52242. Received July 1, 2002; revision requested August 28; final revision received March 14, 2003; accepted May 19. L.T.M. supported by National Heart, Lung, and Blood Institute grant R01 HL48050 "CT Vascular Calcium—An Epidemiologic Study in the Young." Address correspondence to W.S. (e-mail: william-stanford@uiowa.edu).

PURPOSE: To determine whether differences in body mass index (BMI) and image section levels representing the proximal through the distal sections of the heart are associated with attenuation differences in images of calcium phantoms scanned during computed tomographic (CT) imaging of study subjects.

MATERIALS AND METHODS: Mean attenuation values for three calcium phantoms (each with a different calcium hydroxyapatite concentration), as measured at each of four different image section levels, were obtained for 691 participants in the Muscatine CT Vascular Calcium Study. The subjects were grouped according to sex-specific BMI quartiles, and the degree of attenuation in each phantom was investigated as a function of image section level and BMI quartile. Spearman rank order correlation coefficients and one-, two-, and three-factor repeated-measures analysis of variance were used to examine the association between section level and BMI and the mean phantom attenuations.

RESULTS: Attenuation was, for the most part, significantly associated with both section level (P < .005) and BMI quartile (P < .0025–.05). The degree of attenuation tended to decrease in images obtained at the more distal cardiac levels and to increase with increasing BMI quartile.

CONCLUSION: Differences in attenuation related to BMI and image section level appear to have a significant effect on current calcium scoring methods.

© RSNA, 2004

Index terms: Computed tomography (CT), experimental studies, 54.12118 • Coronary vessels, calcification, 54.75, 54.81 • Coronary vessels, CT, 54.12118 • Phantoms • Test objects

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