TY - JOUR
T1 - Coronary artery calcium
T2 - A multi-institutional, multimanufacturer international standard for quantification at cardiac CT
AU - McCollough, Cynthia H.
AU - Ulzheimer, Stefan
AU - Halliburton, Sandra S.
AU - Shanneik, Kaiss
AU - White, Richard D.
AU - Kalender, Willi A.
PY - 2007/5
Y1 - 2007/5
N2 - Purpose: To develop a consensus standard for quantification of coronary artery calcium (CAC). Materials and Methods: A standard for CAC quantification was developed by a multi-institutional, multimanufacturer international consortium of cardiac radiologists, medical physicists, and industry representatives. This report specifically describes the standardization of scan acquisition and reconstruction parameters, the use of patient, size-specific tube current values to achieve a prescribed image noise, and the use of the calcium mass score to eliminate scanner- and patient size-based variations. An anthropomorphic phantom containing calibration inserts and additional phantom rings were used to simulate small, medium-size, and large patients. The three phantoms were scanned by using the recommended protocols for various computed tomography (CT) systems to determine the calibration factors that relate measured CT numbers to calcium hydroxyapatite density and to determine the tube current values that yield comparable noise values. Calculation of the calcium mass score was standardized, and the variance in Agatston, volume, and mass scores was compared among CT systems. Results: Use of the recommended scanning parameters resulted in similar noise for small, medium-size, and large phantoms with all multi-detector row CT scanners. Volume scores had greater interscanner variance than did Agatston and calcium mass scores. Use of a fixed calcium hydroxyapatite density threshold (100 mg/cm3), as compared with use of a fixed CT number threshold (130 HU), reduced interscanner variability in Agatston and calcium mass scores. With use of a density segmentation threshold, the calcium mass score had the smallest variance as a function of patient size. Conclusion: Standardized quantification of CAC yielded comparable image noise, spatial resolution, and mass scores among different patient sizes and different CT systems and facilitated reduced radiation dose for small and medium-size patients.
AB - Purpose: To develop a consensus standard for quantification of coronary artery calcium (CAC). Materials and Methods: A standard for CAC quantification was developed by a multi-institutional, multimanufacturer international consortium of cardiac radiologists, medical physicists, and industry representatives. This report specifically describes the standardization of scan acquisition and reconstruction parameters, the use of patient, size-specific tube current values to achieve a prescribed image noise, and the use of the calcium mass score to eliminate scanner- and patient size-based variations. An anthropomorphic phantom containing calibration inserts and additional phantom rings were used to simulate small, medium-size, and large patients. The three phantoms were scanned by using the recommended protocols for various computed tomography (CT) systems to determine the calibration factors that relate measured CT numbers to calcium hydroxyapatite density and to determine the tube current values that yield comparable noise values. Calculation of the calcium mass score was standardized, and the variance in Agatston, volume, and mass scores was compared among CT systems. Results: Use of the recommended scanning parameters resulted in similar noise for small, medium-size, and large phantoms with all multi-detector row CT scanners. Volume scores had greater interscanner variance than did Agatston and calcium mass scores. Use of a fixed calcium hydroxyapatite density threshold (100 mg/cm3), as compared with use of a fixed CT number threshold (130 HU), reduced interscanner variability in Agatston and calcium mass scores. With use of a density segmentation threshold, the calcium mass score had the smallest variance as a function of patient size. Conclusion: Standardized quantification of CAC yielded comparable image noise, spatial resolution, and mass scores among different patient sizes and different CT systems and facilitated reduced radiation dose for small and medium-size patients.
UR - http://www.scopus.com/inward/record.url?scp=34247546063&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34247546063&partnerID=8YFLogxK
U2 - 10.1148/radiol.2432050808
DO - 10.1148/radiol.2432050808
M3 - Article
C2 - 17456875
AN - SCOPUS:34247546063
VL - 243
SP - 527
EP - 538
JO - Radiology
JF - Radiology
SN - 0033-8419
IS - 2
ER -