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Spiral versus Electron-Beam CT for Coronary Artery Calcium Scoring¹

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).

View larger version (111K): [in a new window]   Figure 1. Two electron-beam CT (EBCT) scans (top) and two spiral CT scans (bottom) obtained in one subject show calcium in the distribution of the left anterior descending artery. The images that best corresponded to each other with respect to regional landmarks were selected. The high-attenuating areas (shaded areas) represent the region within the vessel with an attenuation greater than 130 HU.

View larger version (40K): [in a new window]   Figure 2a. Graphs depict interscan variation in coronary artery calcium scores. (a) The scores obtained by reader 1 for scan 1 versus scan 2 with each of the three scoring algorithms are compared. The scores have been log10 transformed to reduce skewness. The regression line slopes for reader 1, as designated by the linear regression trend lines, are as follows: for 90-HU spiral CT (GECTi-90), x = 0.98 (95% CI: 0.90, 1.06); for 130-HU spiral CT (GECTi-130), x = 0.98 (95% CI: 0.92, 1.05); and for electron-beam CT (EBCT), x = 0.96 (95% CI: 0.92, 1.01). (b) The scores obtained by reader 2 for scan 1 versus scan 2 with each of the three scoring algorithms are compared. The scores have been log10 transformed to reduce skewness. The regression line slopes for reader 2, as designated by the linear regression trend lines, are as follows: for 90-HU spiral CT (GECTi-90), x = 0.98 (95% CI: 0.93, 1.02); for 130-HU spiral CT (GECTi-130), x = 0.99 (95% CI: 0.97, 1.02); and for electron-beam CT (EBCT), x = 0.97 (95% CI: 0.93, 1.00). There is no significant difference in the regression lines among the scoring algorithms for either reader.

View larger version (34K): [in a new window]   Figure 2b. Graphs depict interscan variation in coronary artery calcium scores. (a) The scores obtained by reader 1 for scan 1 versus scan 2 with each of the three scoring algorithms are compared. The scores have been log10 transformed to reduce skewness. The regression line slopes for reader 1, as designated by the linear regression trend lines, are as follows: for 90-HU spiral CT (GECTi-90), x = 0.98 (95% CI: 0.90, 1.06); for 130-HU spiral CT (GECTi-130), x = 0.98 (95% CI: 0.92, 1.05); and for electron-beam CT (EBCT), x = 0.96 (95% CI: 0.92, 1.01). (b) The scores obtained by reader 2 for scan 1 versus scan 2 with each of the three scoring algorithms are compared. The scores have been log10 transformed to reduce skewness. The regression line slopes for reader 2, as designated by the linear regression trend lines, are as follows: for 90-HU spiral CT (GECTi-90), x = 0.98 (95% CI: 0.93, 1.02); for 130-HU spiral CT (GECTi-130), x = 0.99 (95% CI: 0.97, 1.02); and for electron-beam CT (EBCT), x = 0.97 (95% CI: 0.93, 1.00). There is no significant difference in the regression lines among the scoring algorithms for either reader.