Martin J. Willemink MD, Presenter: Nothing to Disclose

Richard A. P. Takx MD, Abstract Co-Author: Nothing to Disclose

Mathias Prokop MD, PhD, Abstract Co-Author: Speakers Bureau, Bayer AG Speakers Bureau, Bracco Group Speakers Bureau, Toshiba Corporation Speakers Bureau, Koninklijke Philips Electronics NV Research Grant, Toshiba Corporation

Johan De Mey, Abstract Co-Author: Research Grant, General Electric Company

Marco Das MD, Abstract Co-Author: Research Consultant, Bayer AG Research Grant, Siemens AG Speakers Bureau, Siemens AG

Pim A. De Jong MD, PhD, Abstract Co-Author: Nothing to Disclose

Ricardo P.J. Budde MD, PhD, Abstract Co-Author: Nothing to Disclose

Arnold Schilham PhD, Abstract Co-Author: Nothing to Disclose

Ronald L.A.W. Bleys MD, PhD, Abstract Co-Author: Nothing to Disclose

Nico Buls DSc, PhD, Abstract Co-Author: Medical Advisory Board, General Electric Company

Joachim Ernst Wildberger MD, PhD, Abstract Co-Author: Nothing to Disclose

Tim Leiner MD, PhD, Abstract Co-Author: Speakers Bureau, Koninklijke Philips Electronics NV Consultant, Bayer AG Research Grant, Bracco Group

Coronary artery calcifications have emerged as an important biomarker for cardiovascular risk stratification. New guidelines recommend evaluation of these calcifications using cardiac computed tomography (CT) in asymptomatic adults with low-to-intermediate and intermediate cardiovascular risk, concerning approximately 40% of the United States adult population. Treatment strategies depend on coronary artery calcification scores on CT. However, it is unknown whether different new generation CT scanners result in similar Agatston scores. Therefore, the purpose was to determine the inter-vendor variability of coronary artery calcifications expressed as Agatston scores with state-of-the-art CT scanners from the four major vendors.

We evaluated the differences in coronary calcium scores between state-of-the-art CT scanners from four different vendors using fifteen ex-vivo human hearts placed in a commercially available anthropomorphic chest phantom. These hearts were scanned with unenhanced prospectively ECG-triggered step-and-shoot protocols at equal radiation dose settings. Thickness and increment of slices were 3mm. Agatston scores, calcification volume and mass scores were quantified with clinically used semi-automatic software from the same vendor as the CT system. Differences were analyzed with the Friedman test (significance level P<0.05).

Fourteen hearts had coronary calcifications. Agatston scores, calcification volume and mass scores differed significantly (P<0.05 for all) between CT scanners. Median (interquartile range) Agatston scores were 332 (114-1135), 353 (172-1246), 410 (177-1454), and 469 (183-1381), respectively. Maximum Agatston score differences between vendors ranged from 304 (20%) to 543 (25%) points. Median (interquartile range) calcification volume scores were 251 (82-883), 290 (144-975), 326 (148-1164), and 169 (84-497) mm3, respectively. Median (interquartile range) calcification mass scores were 70 (27-245), 84 (42-326), 85 (43-337), and 69 (35-246) mg, respectively.

CT scanners from different vendors result in significantly different Agatston scores, calcification volume scores and mass scores. 

Dependent on the CT vendor of a hospital, differences in coronary calcium scoring may result in different treatment strategies.

Willemink, M, Takx, R, Prokop, M, De Mey, J, Das, M, De Jong, P, Budde, R, Schilham, A, Bleys, R, Buls, N, Wildberger, J, Leiner, T, Coronary Artery Calcification Scoring with CT Scanners from Four Different Vendors Results in Different Scores.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13016027.html