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DOI:10.2214/AJR.07.2979
AJR 2008; 190:917-922
© American Roentgen Ray Society

Original Research

Coronary Calcium Screening Using Low-Dose Lung Cancer Screening: Effectiveness of MDCT with Retrospective Reconstruction

Sung Mok Kim1, Myung Jin Chung1, Kyung Soo Lee1, Yeon Hyun Choe1, Chin A. Yi1 and Bong-Keun Choe2

1 Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku, Seoul 135-710, Korea.
2 Department of Preventive Medicine, School of Medicine, Kyunghee University, Seoul, Korea.

OBJECTIVE. The purpose of our study was to show the usefulness of nongated low-dose chest CT for coronary screening by comparing the results of coronary artery calcium measurement with that of dedicated calcium-scoring CT.

MATERIALS AND METHODS. One hundred twenty-eight consecutive participants (all men; mean age, 52 ± 7 years) underwent low-dose chest CT and calcium-scoring CT with prospective ECG gating using 40-MDCT. Low-dose chest CT volume data were reconstructed as 25-cm field of view and three slice thicknesses: 1, 2.5, and 5 mm. For each examination, the lesion area, Agatston calcium score, and calcium mass were measured at 90- and 130-H thresholds. All measurements (130-H threshold) from the calcium-scoring CT were used as reference standards. Spearman's correlation test was used to compare the results.

RESULTS. Among the low-dose chest CT examinations, sensitivity was best determined with a 1-mm slice thickness at 130 H and 2.5-mm slice thickness at 90 H. Specificity was best determined with a 5-mm slice thickness at 130 H. Accuracy (90%) was best determined with a 2.5-mm slice thickness at 130 H. Of all protocols, calcium area, score, and mass from a 2.5-mm slice thickness at 130 H correlated best with the reference results (r = 0.89 for all three criteria).

CONCLUSION. Using a low radiation dose and nongated MDCT, we can detect coronary artery calcium and obtain results comparable to those obtained with dedicated calcium-scoring CT that uses a higher dose and ECG gating.

Keywords: calcium-scoring CT • coronary artery calcium • lung cancer screening • MDCT • radiation dose • screening


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