| Xiao Huawei,Wang Xiangquan,Yang Panfeng,Wang Ling,Xu Jian.Feasibility of coronary artery calcium scoring assessment with ultra-low-dose chest CT combined with a calcium-aware algorithm[J].Chinese Journal of Radiological Medicine and Protection,2023,43(10):820-826 |
| Feasibility of coronary artery calcium scoring assessment with ultra-low-dose chest CT combined with a calcium-aware algorithm |
| Received:March 22, 2023 |
| DOI：10.3760/cma.j.cn112271-20230322-00091 |
| KeyWords:Computed tomography Calcium scoring Tin filtration Radiation dose |
| FundProject: |
| Author Name | Affiliation | E-mail | | Xiao Huawei | Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310014, China | | | Wang Xiangquan | Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310014, China | | | Yang Panfeng | Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310014, China | | | Wang Ling | Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310014, China | | | Xu Jian | Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310014, China | hzxj_610@163.com |
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| Abstract:: |
| Objective To evaluate the feasibility of coronary artery calcium (CAC) detection, quantification and risk classification using ultra-low-dose chest CT (ULD-CT) combined with a calcium-aware algorithm. Methods A total of 115 patients were prospectively enrolled from April to October 2022 at Zhejiang Provincial People's Hospital, who underwent a standard calcium scoring CT (CACS-CT) scan followed by an additional ULD-CT scan. CACS-CT adopted a prospective ECG-triggered sequence scan with a tube voltage of 120 kVp, and the reconstruction algorithm with Qr36 (group CACS-CTQr). ULD-CT adopted non-ECG-triggered high-pitch scan with a tube voltage of Sn 100 kVp, and the standard algorithm Qr36 (group ULD-CTQr) and calcium-aware algorithm Sa36 (group ULD-CTSa) were respectively used to reconstruct two groups of images. Taking the CAC detection of CACS-CT as a reference, the accuracy of ULD-CT for detecting CAC was calculated, and kappa was used to evaluate the agreement of CAC detection between scanning protocols. The agreement of CACS quantification between scanning protocols was assessed using intraclass correlation coefficients (ICC) and Bland-Altman plots, and the agreement of risk classification between scanning protocols was assessed using weighted kappa. Results The CAC was found in 66.96% (77/115) of patients in CACS-CTQr. Taking the CAC detection in CACS-CTQr as a reference, the sensitivity of CAC detection in ULD-CTQr and ULD-CTSa was 96.1% and 97.4%, respectively, and the specificity was 94.73% (k= 0.902, 0.921). The CACS for ULD-CTQr and ULD-CTSa was lower than that for CACS-CTQr (3.6, 6.2 vs. 8.5; P< 0.001), but strongly correlated with CACS for CACS-CTQr (r= 0.983, P< 0.001). The mean difference in CACS for ULD-CTSa and CACS-CTQr was smaller (12.33), and the agreement was better (ICC= 0.992). The agreement of risk classifications between ULD-CTSa and CACS-CTQr was relatively high (weighted k= 0.936), and the reclassification rate (6.08%) was relatively low. The effective radiation dose for ULD-CT was reduced by approximately 77.22% compared with that for CACS-CT. Conclusions It is feasible to evaluate CACS using Non-ECG-triggered ULD-CT combined with a calcium-aware algorithm. |
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