We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress hp
Sign In
Advertise with Us
GLOBETECH PUBLISHING LLC

Download Mobile App




Visual Ordinal CAC Assessment on Chest CT Found to Have High Diagnostic Performance

By MedImaging International staff writers
Posted on 28 Apr 2022
Image: Visual ordinal scoring of coronary artery calcium on chest CT (Photo courtesy of Unsplash)
Image: Visual ordinal scoring of coronary artery calcium on chest CT (Photo courtesy of Unsplash)

Current guidelines recommend visual evaluation of coronary artery calcium (CAC) on all non-gated non-contrast chest CT examinations. However, chest CT examinations are often performed with contrast material administration. Now, a new study has found that visual ordinal CAC assessment on both contrast-enhanced and non-contrast chest CT has high diagnostic performance, prognostic utility, and interobserver agreement.

The retrospective study conducted by researchers from Toronto General Hospital, University Health Network (Toronto, ON, Canada) included 260 patients (mean age, 60; 158 male, 102 female) who underwent both non-gated chest CT (contrast-enhanced in 116 patients; non-contrast in 144 patients) and cardiac calcium-score CT within a 12-month interval. A cardiothoracic radiologist visually assessed CAC on chest CT using an ordinal scale: absent, mild, moderate, or severe. Cardiac CT Agatston calcium scores were quantified according to established guidelines and categorized as absent (0), mild (1-99), moderate (100-299), or severe (≥300). Diagnostic performance of chest CT for presence of CAC was assessed using cardiac CT as reference standard. Major adverse cardiac events (MACE) were assessed as a composite of cardiovascular death and myocardial infarction and evaluated using Cox proportional hazards models. A second cardiothoracic radiologist performed visual CAC assessments in a random subset of 50 chest CT examinations to assess interobserver agreement.

The findings revealed that for the presence of any CAC on cardiac CT, contrast-enhanced and non-contrast chest CT had sensitivity of 83% and 90% and specificity of 100% and 100%. CAC present on cardiac CT was misclassified as absent on 13 contrast-enhanced and 10 non-contrast chest CT examinations; Agatston score was less than 30 in all such patients, and none experienced MACE. Visual ordinal CAC score was associated with MACE for contrast-enhanced [hazard ratio (HR)=4.5 [95% CI 1.2, 16.4], p=.02) and non-contrast (HR=3.4 [95% CI 1.5, 7.8], p=.003) chest CT. Interobserver agreement was excellent for contrast-enhanced (κ =0.95) and non-contrast (κ =0.89) chest CT.

“Visual ordinal CAC assessment on both contrast-enhanced and non-contrast chest CT has high diagnostic performance, prognostic utility, and interobserver agreement,” confirmed corresponding author Kate Hanneman, MD, MPH, from Toronto General Hospital, University Health Network in Ontario. “Routine reporting of CAC on all chest CT examinations regardless of clinical indication and contrast material administration could identify a large number of patients with previously unknown CAC who might benefit from preventive treatment.”

Related Links:
University Health Network 

New
Ultrasound Needle Guidance System
SonoSite L25
New
High-Precision QA Tool
DEXA Phantom
New
Diagnostic Ultrasound System
DC-80A
Ultrasound Imaging System
P12 Elite

Channels

Ultrasound

view channel
Image: The new implantable device for chronic pain management is small and flexible (Photo courtesy of The Zhou Lab at USC)

Wireless Chronic Pain Management Device to Reduce Need for Painkillers and Surgery

Chronic pain affects millions of people globally, often leading to long-term disability and dependence on opioid medications, which carry significant risks of side effects and addiction.... Read more

Nuclear Medicine

view channel
Image: The diagnostic tool could improve diagnosis and treatment decisions for patients with chronic lung infections (Photo courtesy of SNMMI)

Novel Bacteria-Specific PET Imaging Approach Detects Hard-To-Diagnose Lung Infections

Mycobacteroides abscessus is a rapidly growing mycobacteria that primarily affects immunocompromised patients and those with underlying lung diseases, such as cystic fibrosis or chronic obstructive pulmonary... Read more

Imaging IT

view channel
Image: The new Medical Imaging Suite makes healthcare imaging data more accessible, interoperable and useful (Photo courtesy of Google Cloud)

New Google Cloud Medical Imaging Suite Makes Imaging Healthcare Data More Accessible

Medical imaging is a critical tool used to diagnose patients, and there are billions of medical images scanned globally each year. Imaging data accounts for about 90% of all healthcare data1 and, until... Read more
Copyright © 2000-2025 Globetech Media. All rights reserved.