Radiology 2001 Oct;221(1):213-21
Spiral versus electron-beam CT for coronary artery calcium scoring.
Goldin JG, Yoon HC, Greaser LE 3rd, Heinze SB, McNitt-Gray MM, Brown MS, Sayre
JW, Emerick AM, Aberle DR.
PURPOSE: To determine differences in coronary artery calcium detection,
quantification, and reproducibility, as measured at electron-beam computed
tomography (CT) and subsecond spiral CT with retrospective electrocardiogram
gating in an asymptomatic adult population. MATERIALS AND METHODS: Seventy
subjects asymptomatic for coronary heart disease underwent both electron-beam CT
and subsecond spiral CT. In all subjects, two images each were obtained with
both scanners. Two experienced readers using three different algorithms scored
each of the four scans: one score for the electron-beam CT images and two scores
for the spiral CT images. RESULTS: With a 130-HU threshold for the
quantification of calcium, there were no significant differences in interscan
and interobserver variation in calcium scores between the electron-beam CT and
spiral CT images. There was greater interobserver (P <.001) and interscan (P
<.03) variation in scores when a 90-HU threshold was used for spiral CT
images. With a 130-HU threshold, when calcium scores were used for clinical risk
stratification, there was a significant difference between the results obtained
with electron-beam CT and those obtained with spiral CT (P <.05). CONCLUSION:
Spiral CT has not yet proved to be a feasible alternative to electron-beam CT
for coronary artery calcium quantification. There are systematic differences
between calcium scores obtained with single-detector array subsecond spiral CT
and those obtained with electron-beam CT.
