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Helical and Single-Slice Conventional CT Versus Electron Beam CT for the Quantification of Coronary Artery Calcification

Christoph R. Becker1, Tobias F. Jakobs1, Sibel Aydemir2, Alexander Becker3, Andreas Knez3, Uwe J. Schoepf1, Roland Bruening1, Ralph Haberl3 and Maximilian F. Reiser1

1 Department of Diagnostic Radiology, Ludwig-Maximilians-University, Klinikum Grosshadern, Marchioninistr. 15, D-81377 Munich, Germany.
2 Department of Medical Data Processing, Biometry, and Epidemiology, Ludwig-Maximilians-University, D-81377 Munich, Germany.
3 Department of Cardiology, Ludwig-Maximilians-University, D-81377 Munich, Germany.



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  		Fig. 1. —Regression plot shows scores from electron beam CT and ECG-triggered single-slice conventional CT in 50 patients. Linear correlation follows equation of electron beam CT score = 8.5 + 1.006 conventional CT score (r = 0.976). Note that calcium scores are not normally distributed, and high correlation is shown for wide range of scores.

 


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  		Fig. 2. —Whisker plot shows systematic error (point) and limit of agreement (range) for different scan modes. Note systematic error and agreement to initial electron beam CT score are best using repeated electron beam CT and ECG-triggered single-slice conventional CT. Other scan modes for conventional CT show lower agreement and systematic error of measurement.

 


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  		Fig. 3A. —51-year-old man with heart rate of 50 beats per minute. Electron beam CT scan shows small calcifications in left anterior descending coronary artery (arrow).

 


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  		Fig. 3C. —51-year-old man with heart rate of 50 beats per minute. Electron beam CT scan shows calcifications of right coronary artery (arrow). ECG misregistration may have caused blurring of calcification.

 


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  		Fig. 3B. —51-year-old man with heart rate of 50 beats per minute. ECG-triggered single-slice conventional CT scan shows calcification of left coronary artery (arrow).

 


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  		Fig. 3D. —51-year-old man with heart rate of 50 beats per minute. ECG-triggered single-slice conventional CT scan shows no motion artifacts (arrow). This patient's calcium scores were 605 and 597 with electron beam CT and conventional CT, respectively.

 


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  		Fig. 4A. —62-year-old man with heart rate of 70 beats per minute. Streak artifacts are found in conventional CT because of longer exposure time. Soft-tissue window setting (window width, 45; window height, 350) shows artifacts (arrow) typically seen in right coronary artery (circle).

 


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  		Fig. 4B. —62-year-old man with heart rate of 70 beats per minute. In different window setting (window width, 130; window height, 1), area of calcification is clearly seen (circle). Streak artifacts do not enlarge area of plaque because they are less than threshold of 130 H.

 

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