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Optimal Cardiac Phase for Coronary Artery Calcium Scoring on Single-Source 64-MDCT Scanner: Least Interscan Variability and Least Motion Artifacts

Noriaki Matsuura1, Jun Horiguchi2, Hideya Yamamoto3, Nobuhiko Hirai2, Tetsuji Tonda4, Nobuoki Kohno3 and Katsuhide Ito1

1 Department of Radiology, Division of Medical Intelligence and Informatics, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
2 Department of Clinical Radiology, Hiroshima University Hospital, 1-2-3, Kasumi-cho, Minami-ku, Hiroshima 734-8551, Japan.
3 Department of Molecular and Internal Medicine, Division of Clinical Medical Science, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
4 Department of Environmetrics and Biometrics, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.


Figure 1
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  		Fig. 1A —Grading of intensity of motion artifacts from coronary artery calcium. Cardiac CT calcium scoring image in 63-year-old woman shows grade 1 (arrow): none, no motion artifacts from coronary artery calcium.

 

Figure 2
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  		Fig. 1B —Grading of intensity of motion artifacts from coronary artery calcium. Cardiac CT calcium scoring image in 68-year-old man shows grade 2 (arrow): minor, streaking artifacts from coronary artery calcium or blurred margin of coronary artery calcium.

 

Figure 3
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  		Fig. 1C —Grading of intensity of motion artifacts from coronary artery calcium. Cardiac CT calcium scoring image in 73-year-old man shows grade 3 (arrow): major, coronary artery calcium with star-shaped or doubling artifacts.

 

Figure 4
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  		Fig. 2A —Graphs show interscan variability of coronary artery calcium scoring for three heart rate groups. Interscan variability of Agatston (dark gray), volume (medium gray), and mass (white) scores on nine cardiac phases are shown for all patients (A); low-heart-rate group (B) and high-heart-rate group (C) are also shown. Graphs show means (bars), mean plus SD (upper vertical line), and median (lower vertical line). Two-factor factorial analysis of variance revealed significant differences between cardiac phases (p < 0.01); however, there were no significant differences among scoring algorithms (all patients, p = 0.46; low-heart-rate group, p = 0.58; and high-heart-rate group, p = 0.75). Scheffé test, however, showed no statistical difference between cardiac phases.

 

Figure 5
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  		Fig. 2B —Graphs show interscan variability of coronary artery calcium scoring for three heart rate groups. Interscan variability of Agatston (dark gray), volume (medium gray), and mass (white) scores on nine cardiac phases are shown for all patients (A); low-heart-rate group (B) and high-heart-rate group (C) are also shown. Graphs show means (bars), mean plus SD (upper vertical line), and median (lower vertical line). Two-factor factorial analysis of variance revealed significant differences between cardiac phases (p < 0.01); however, there were no significant differences among scoring algorithms (all patients, p = 0.46; low-heart-rate group, p = 0.58; and high-heart-rate group, p = 0.75). Scheffé test, however, showed no statistical difference between cardiac phases.

 

Figure 6
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  		Fig. 2C —Graphs show interscan variability of coronary artery calcium scoring for three heart rate groups. Interscan variability of Agatston (dark gray), volume (medium gray), and mass (white) scores on nine cardiac phases are shown for all patients (A); low-heart-rate group (B) and high-heart-rate group (C) are also shown. Graphs show means (bars), mean plus SD (upper vertical line), and median (lower vertical line). Two-factor factorial analysis of variance revealed significant differences between cardiac phases (p < 0.01); however, there were no significant differences among scoring algorithms (all patients, p = 0.46; low-heart-rate group, p = 0.58; and high-heart-rate group, p = 0.75). Scheffé test, however, showed no statistical difference between cardiac phases.

 

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