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Cardiac Imaging |
1 From the Department of Radiology, College of Medicine (W.S., B.H.T., S.D.H., M.C.B.) and Department of Biostatistics, College of Public Health (T.L.B.), University of Iowa, 200 Hawkins Dr, Iowa City, IA 52242. From the 2002 RSNA scientific assembly. Received July 18, 2002; revision requested September 5; final revision received May 26, 2003; accepted July 15. Supported in part by the Garrick Family Foundation, Atherton, Calif. Address correspondence to W.S. (e-mail: william-stanford@uiowa.edu).
PURPOSE: To compare coronary artery calcium scores from a multi–detector row helical computed tomographic (CT) scanner with those from an electron-beam CT scanner, with emphasis on subjects with calcium scores less than 400.
MATERIALS AND METHODS: Seventy-eight asymptomatic subjects (37 women, 41 men; age range, 39–78 years; mean age, 54.2 years) underwent multi–detector row CT and electron-beam CT. Volume and Agatston scores were calculated with a workstation. Statistical analyses included assessment of association between calcium scores from two scanners, calculation of percent absolute difference to assess score variability between scanners, equivalence analysis, construction of Bland-Altman plots to assess agreement between scores, and assessment of changes in score grouping and risk criteria based on score differences between scanners.
RESULTS: Electron-beam CT calcium scores were higher than multi–detector row CT scores. Linear association between calcium scores obtained from paired scans was significant (r = 0.96–0.99, P < .001). Mean percent absolute differences were 67.9% and 65.0% for volume and Agatston scores, respectively (48.6% and 46.3% for corresponding natural log–transformed scores). In subjects with a score of 11 or greater, mean percent absolute differences between electron-beam CT and multi–detector row CT scores ranged from 15% to 30% (<10% for natural log–transformed calcium scores). With a 20% equivalence limit, calcium scores from the two scanners were statistically equivalent (P < .05). Score grouping would have been subject to change in 12 (11 increased and one decreased; six with scores of 11 or greater), and possible risk management decisions would have been subject to change in eight (16%) of 51 subjects who underwent electron-beam CT versus multi–detector row CT scanning.
CONCLUSION: Multi–detector row CT appears to be comparable to electron-beam CT for coronary calcification screening, except in subjects with a calcium score less than 11.
© RSNA, 2004
Index terms: Computed tomography (CT), comparative studies • Computed tomography (CT), electron beam, 54.12119 • Computed tomography (CT), helical, 54.12115 • Computed tomography (CT), multi–detector row, 54.12119 • Coronary vessels, calcification, 54.812
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