Sensitivity to detect small coronary artery calcium lesions with varying slice thickness using electron beam tomography.

Abstract:

RATIONALE AND OBJECTIVE:To estimate the sensitivity to find small coronary artery calcium lesions with use of different slice widths with electron beam tomography. MATERIALS AND METHODS:Two studies were performed. Study 1 utilized double scanning of a stationary cork phantom with three different slice thickness (1.5, 3, and 6 mm). Fifty different calcific lesions (all <20 mm2 in area) fitted in 10 cork coronary arteries were utilized. The calcium foci area, peak value and score were measured and compared. In group 2, 30 patients underwent coronary artery calcium (CAC) screen studies. Each patient was scanned with both 3-mm and 6-mm scan widths in a same study time. Lesions with < 20 mm2 of area of CAC were measured on both 3-mm and 6-mm images. The mean and peak Hounsfield unit measure, and Agatston score were compared between both images. RESULTS:In the cork study, the sensitivity to detect small calcium foci were 96% (48/50), 82% (41/50), and 34% (17/50) in images with 1.5-, 3-, and 6-mm slice thickness, respectively. There is a smaller value in mass, and calcium volume in 6-mm images than 1.5-mm and 3-mm images ( P< 0.001). There was no significant difference between the true value and measured value from 1.5-mm and 3-mm images. In the human study, 18 (30%) of 60 CAC lesions with an area < 20 mm2 defined on 3 mm images were not visible on 6-mm images. Sensitivity of small lesions (P< 5 mm2) was 48% using 6-mm slices. There was a smaller value in CAC area, mean and peak Hounsfield units and score measured from 6-mm images, as compared with 3 mm slices ( P< 0.05). CONCLUSION:Thinner slice imaging has a higher sensitivity to detect small calcium focus. There was no significant change in score between 3 mm and 1.5 mm on the cork phantom study. However, the use of 6-mm slices should be discouraged, as this protocol both underestimates calcific mass and misses a significant number of calcific lesions in both a phantom and human study.

journal_name

Invest Radiol

journal_title

Investigative radiology

authors

Mao S,Child J,Carson S,Liu SC,Oudiz RJ,Budoff MJ

doi

10.1097/01.RLI.0000055289.97726.B1

keywords:

subject

Has Abstract

pub_date

2003-03-01 00:00:00

pages

183-7

issue

3

eissn

0020-9996

issn

1536-0210

journal_volume

38

pub_type

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