277 results on '"Calcium scoring"'
Search Results
252. 111 INTERGRATION OF CT CALCIUM SCORING AND CT CORONARY ANGIOGRAMS INTO A TERTIARY HOSPITAL RAPID ACCESS CHEST PAIN CLINIC
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N Bunce, J Vlahos, Lynne Millar, N Sheikh, and K Townsend
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medicine.medical_specialty ,Percutaneous ,medicine.diagnostic_test ,business.industry ,Nice ,Chest pain ,medicine.disease ,Coronary artery disease ,Calcium scoring ,Angiography ,Heart rate ,Rapid access ,Medicine ,Radiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,computer ,computer.programming_language - Abstract
Introduction In March 2010 NICE published guidelines for assessment of patients with chest pain of recent onset based on their pre-test likelihood (PL) for coronary artery disease (CAD). A novel aspect was the use of a CT calcium score (CaS) and CT coronary angiography (CTCA) to exclude CAD in low risk patients. Here we report our experience of integrating this approach to our Rapid Access Chest Pain Clinic (RACPC) over a 32 month period. Methods Data was retrospectively analysed from consecutive patients attending RACPC, referred for CT. Both CaS and CTCA were performed by default by our radiology department, regardless of CaS, using older 64-multislice and newer generation 128-multislice CT scanners (the latter capable of flash acquisition and prospective gating). The radiation dose (RD) in milli-Sieverts (mSv) received by each patient was calculated from the dose-length product. Patients with significant CAD on CTCA (at least 1 >50% lesion) were referred for invasive angiography (XA). Results 156 patients were included (Males n=68, females n=88; mean age 52.2±8.7). The median RD received was 4.45 mSv (0.48–20.59); patients scanned in the newer generation CT scanner received significantly less RD than those in the older scanner (median 2.54 (0.48–8.75) vs 11.55(8.07–20.59) mSv respectively, p 1 were significantly older (mean age 55±7 years, p 90%, who NICE would have recommended to treat as stable angina without investigation (n=8), 3 had prognostic disease requiring either percutaneous or surgical revascularisation. Conclusions A CaS of 0 in symptomatic patients does not rule out significant and prognostic CAD, particularly in younger patients. Prospective gating with 128-multislice CT scanners in patients with optimum heart rate and rhythm significantly reduces the RD. Given that 50% of our patients recommended by the NICE guidelines to have XA as their first line investigation had no significant disease on CTCA, it is reasonable to consider CaS and CTCA as a first line investigation in selected higher risk patients. Our findings in the highest risk patients (PL CAD>90%), who NICE recommend treating medically as stable angina, suggest that this group may benefit from investigation with XA being the most appropriate choice.
- Published
- 2013
253. ISOTROPIC CALCIUM SCORING USING 0.5 MM RECONSTRUCTION MAY BE MORE SENSITIVE THAN STANDARD CONTRAST ENHANCED CT ANGIOGRAPHY IN DETECTING SUBCLINICAL ATHEROSCLEROSIS, USING 320-DETECTOR ROW CT
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Usman S. Khokhar, Michael Cortegiano, Ammar Chaudhry, Alexander J. Abramowicz, Michael Poon, Anum Aslam, and Szilard Voros
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medicine.medical_specialty ,Enhanced ct ,medicine.diagnostic_test ,business.industry ,media_common.quotation_subject ,Detector ,Calcium scoring ,Subclinical atherosclerosis ,Angiography ,Medicine ,Contrast (vision) ,cardiovascular diseases ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Nuclear medicine ,media_common - Published
- 2013
254. Coronary artery calcium scoring for ruling-out acute coronary syndrome in chest pain CT.
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Hinzpeter R, Higashigaito K, Morsbach F, Benz D, Manka R, Seifert B, Keller DI, and Alkadhi H
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- Acute Coronary Syndrome diagnostic imaging, Coronary Vessels pathology, Female, Humans, Male, Middle Aged, Myocardial Infarction diagnosis, Myocardial Infarction diagnostic imaging, Retrospective Studies, Tomography, X-Ray Computed, Acute Coronary Syndrome diagnosis, Chest Pain diagnostic imaging, Coronary Vessels diagnostic imaging, Vascular Calcification diagnostic imaging
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- 2017
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255. Detection and quantification of coronary calcium from dual energy chest x-rays: Phantom feasibility study.
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Zhou B, Wen D, Nye K, Gilkeson RC, Eck B, Jordan D, and Wilson DL
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- Artifacts, Feasibility Studies, Humans, Calcium metabolism, Coronary Vessels diagnostic imaging, Coronary Vessels metabolism, Phantoms, Imaging, Radiography, Thoracic instrumentation, Tomography, X-Ray Computed instrumentation
- Abstract
Purpose: We have demonstrated the ability to identify coronary calcium, a reliable biomarker of coronary artery disease, using nongated, 2-shot, dual energy (DE) chest x-ray imaging. Here we will use digital simulations, backed up by measurements, to characterize DE calcium signals and the role of potential confounds such as beam hardening, x-ray scatter, cardiac motion, and pulmonary artery pulsation. For the DE calcium signal, we will consider quantification, as compared to CT calcium score, and visualization., Methods: We created stylized and anatomical digital 3D phantoms including heart, lung, coronary calcium, spine, ribs, pulmonary artery, and adipose. We simulated high and low kVp x-ray acquisitions with x-ray spectra, energy dependent attenuation, scatter, ideal detector, and automatic exposure control (AEC). Phantoms allowed us to vary adipose thickness, cardiac motion, etc. We used specialized dual energy coronary calcium (DECC) processing that includes corrections for scatter and beam hardening., Results: Beam hardening over a wide range of adipose thickness (0-30 cm) reduced the change in intensity of a coronary artery calcification (ΔI
CAC ) by < 3% in DECC images. Scatter correction errors of ±50% affected the calcium signal (ΔICAC ) in DECC images ±9%. If a simulated pulmonary artery fills with blood between exposures, it can give rise to a residual signal in DECC images, explaining pulmonary artery visibility in some clinical images. Residual misregistration can be mostly compensated by integrating signals in an enlarged region encompassing registration artifacts. DECC calcium score compared favorably to CT mass and volume scores over a number of phantom perturbations., Conclusion: Simulations indicate that proper DECC processing can faithfully recover coronary calcium signals. Beam hardening, errors in scatter estimation, cardiac motion, calcium residual misregistration etc., are all manageable. Simulations are valuable as we continue to optimize DE coronary calcium image processing and quantitative analysis., (© 2017 American Association of Physicists in Medicine.)- Published
- 2017
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256. [Value of cardiac CT in the diagnostic work-up of coronary artery disease : Update 2017].
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Meyer M and Henzler T
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- Coronary Stenosis diagnostic imaging, Humans, Coronary Angiography methods, Coronary Artery Disease diagnostic imaging, Tomography, X-Ray Computed methods
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The quantification of coronary calcifications using noncontrast-enhanced computed tomography (CT) as well as coronary CT angiography (cCTA) have rapidly evolved in the recent years. Nowadays, both techniques are increasingly clinically accepted regarding risk stratification and accurate exclusion of significant coronary artery disease (CAD). The higher acceptance of cCTA is mainly based on the higher robustness, lower radiation exposure through continuous technical innovations as well as by the growing scientific evidence. The poor predictive value of cCTA for predicting the hemodynamic significance of detected coronary artery stenosis may be improved by continuous technical developments in the area of functional imaging. The aim of this educational article is to summarize the current clinical status of calcium scoring and morphological cCTA and to provide an overview on novel functional CT techniques.
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- 2017
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257. Practical determination of aortic valve calcium volume score on contrast-enhanced computed tomography prior to transcatheter aortic valve replacement and impact on paravalvular regurgitation: Elucidating optimal threshold cutoffs.
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Bettinger N, Khalique OK, Krepp JM, Hamid NB, Bae DJ, Pulerwitz TC, Liao M, Hahn RT, Vahl TP, Nazif TM, George I, Leon MB, Einstein AJ, and Kodali SK
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- Aged, Aged, 80 and over, Aortic Valve physiopathology, Aortic Valve surgery, Aortic Valve Insufficiency physiopathology, Aortic Valve Stenosis physiopathology, Aortic Valve Stenosis surgery, Area Under Curve, Calcinosis physiopathology, Calcinosis surgery, Echocardiography, Transesophageal, Female, Heart Valve Prosthesis, Humans, Logistic Models, Male, Multivariate Analysis, Predictive Value of Tests, Proportional Hazards Models, ROC Curve, Retrospective Studies, Risk Assessment, Risk Factors, Severity of Illness Index, Transcatheter Aortic Valve Replacement instrumentation, Treatment Outcome, Aortic Valve diagnostic imaging, Aortic Valve pathology, Aortic Valve Insufficiency etiology, Aortic Valve Stenosis diagnostic imaging, Calcinosis diagnostic imaging, Contrast Media administration & dosage, Tomography, X-Ray Computed, Transcatheter Aortic Valve Replacement adverse effects
- Abstract
Background: The threshold for the optimal computed tomography (CT) number in Hounsfield Units (HU) to quantify aortic valvular calcium on contrast-enhanced scans has not been standardized. Our aim was to find the most accurate threshold to predict paravalvular regurgitation (PVR) after transcatheter aortic valve replacement (TAVR)., Methods: 104 patients who underwent TAVR with the CoreValve prosthesis were studied retrospectively. Luminal attenuation (LA) in HU was measured at the level of the aortic annulus. Calcium volume score for the aortic valvular complex was measured using 6 threshold cutoffs (650 HU, 850 HU, LA × 1.25, LA × 1.5, LA+50, LA+100). Receiver-operating characteristic (ROC) analysis was performed to assess the predictive value for > mild PVR (n = 16). Multivariable analysis was performed to determine the accuracy to predict > mild PVR after adjustment for depth and perimeter oversizing., Results: ROC analysis showed lower area under the curve (AUC) values for fixed threshold cutoffs (650 or 850 HU) compared to thresholds relative to LA. The LA+100 threshold had the highest AUC (0.81), and AUC was higher than all studied protocols, other than the LA x 1.25 and LA + 50 protocols, where the difference approached statistical significance (p = 0.05, and 0.068, respectively). Multivariable analysis showed calcium volume determined by the LAx1.25, LAx1.5, LA+50, and LA+ 100 HU protocols to independently predict PVR., Conclusions: Calcium volume scoring thresholds which are relative to LA are more predictive of PVR post-TAVR than those which use fixed cutoffs. A threshold of LA+100 HU had the highest predictive value., (Copyright © 2017 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.)
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- 2017
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258. Specificity of variable electron beam computed tomographic calcium scoring in defining angiographic coronary stenoses
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John A. Rumberger, Robert S. Schwartz, Jerome F. Breen, Vincent Yacyshvn, and Patrick F. Sheedy
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medicine.medical_specialty ,Calcium scoring ,business.industry ,medicine ,Radiology ,business ,Nuclear medicine ,Cardiology and Cardiovascular Medicine ,Computed tomographic - Published
- 1996
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259. PROGNOSTIC VALUE OF CORONARY CT ANGIOGRAPHY IN ASYMPTOMATIC POPULATION: COMPARISONS WITH CONVENTIONAL RISK STRATIFICATION ALGORITHM AND CALCIUM SCORING
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Mouaz H. Al-Mallah, Todd C. Villines, Hyuk Jae Chang, Augustin Delago, Philipp A. Kaufmann, Allison Dunning, James K. Min, Leslee J. Shaw, Iksung Cho, Joerg Hausleiter, Benjamin J.W. Chow, Daniel S. Berman, Matthew J. Budoff, Tracy Q. Callister, Gil Raff, Filippo Cademartiri, Stephan Achenbach, and Martin Hadamitzky
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medicine.medical_specialty ,education.field_of_study ,business.industry ,Population ,Coronary ct angiography ,Asymptomatic ,Calcium scoring ,Internal medicine ,Risk stratification ,medicine ,Cardiology ,Radiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,education ,Value (mathematics) - Published
- 2011
260. Automated Quantitative Analysis of Cardiac Medical Images
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Ding, Xiaowei
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- Computer science, calcium scoring, epicardial fat, image registration, image segmentation, medical image analysis, pericardial fat
- Abstract
Studies in clinical medicine often demand the quantitative analysis of medical images. These tasks need careful and time-consuming tracing and labeling on fine image structures, cost expensive medical expert labor and often suffer from low reproducibility. We present a collection of methods that quantify important parameters from cardiac computed tomography (CT) and magnetic resonance imaging (MRI) in a fully-automated mode. We first present atlas-based segmentation, active contours models and graph-based segmentation which are components in our novel framework. We then present our algorithms for automated quantification of epicardial fat volume (EFV) from non-contrast cardiac CT, automated pericardial fat volume (PFV) quantification from water\/fat-resolved whole-heart non-contrast coronary magnetic resonance angiography (MRA) and automated coronary calcium scoring (CCS) from non-contrast cardiac CT images. Algorithm quantification results are validated on test scans with ground truth annotated by expert radiologists. Our approaches may potentially be applied in a clinical setting, allowing for accurate quantification of EFV, PFV and CCS without tedious manual tracing.
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- 2015
261. DIFFERENTIATING ISCHEMIC VERSUS NON-ISCHEMIC CARDIOMYOPATHY: WHAT IS THE ROLE OF CALCIUM SCORING?
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Zehra Husain, Karthikeyan Ananthasubramaniam, and Mouaz al Mallah
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,Ischemia ,Non ischemic cardiomyopathy ,chemistry.chemical_element ,Calcium ,Critical Care and Intensive Care Medicine ,medicine.disease ,Calcium scoring ,chemistry ,Internal medicine ,medicine ,Cardiology ,Social role ,Cardiology and Cardiovascular Medicine ,business - Published
- 2009
262. Calcium Scoring With Computed Tomography
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Thomas C. Gerber and Raymond J. Gibbons
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medicine.diagnostic_test ,business.industry ,Calcinosis ,chemistry.chemical_element ,Computed tomography ,Coronary Artery Disease ,Calcium ,Risk Assessment ,Article ,Radiation risk ,Radiation Protection ,Calcium scoring ,chemistry ,Internal Medicine ,Humans ,Medicine ,Radiometry ,Tomography, X-Ray Computed ,business ,Nuclear medicine ,Relative Biological Effectiveness - Published
- 2009
263. Calcium Scoring Useful in Asymptomatic Patients
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Kerri Wachter
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medicine.medical_specialty ,Calcium scoring ,business.industry ,Internal medicine ,Medicine ,medicine.symptom ,business ,Gastroenterology ,Asymptomatic - Published
- 2007
264. Calcium Scoring Useful in Intermediate CHD Risk
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Kerri Wachter
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medicine.medical_specialty ,Calcium scoring ,business.industry ,Internal medicine ,Cardiology ,medicine ,business ,Chd risk - Published
- 2007
265. The 100 most-cited original articles in cardiac computed tomography: A bibliometric analysis.
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O'Keeffe ME, Hanna TN, Holmes D, Marais O, Mohammed MF, Clark S, McLaughlin P, Nicolaou S, and Khosa F
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- Authorship, Bibliometrics, Humans, Predictive Value of Tests, Research Design statistics & numerical data, Time Factors, Biomedical Research statistics & numerical data, Cardiology statistics & numerical data, Coronary Artery Disease diagnostic imaging, Coronary Vessels diagnostic imaging, Periodicals as Topic statistics & numerical data, Tomography, X-Ray Computed statistics & numerical data, Vascular Calcification diagnostic imaging
- Abstract
Bibliometric analysis is the application of statistical methods to analyze quantitative data about scientific publications. It can evaluate research performance, author productivity, and manuscript impact. To the best of our knowledge, no bibliometric analysis has focused on cardiac computed tomography (CT). The purpose of this paper was to compile a list of the 100 most-cited articles related to cardiac CT literature using Scopus and Web of Science (WOS). A list of the 100 most-cited articles was compiled by order of citation frequency, as well a list of the top 10 most-cited guideline and review articles and the 20 most-cited articles of the years 2014-2015. The database of 100 most-cited articles was analyzed to identify characteristics of highly cited publications. For each manuscript, the number of authors, study design, size of patient cohort and departmental affiliations were cataloged. The 100 most-cited articles were published from 1990 to 2012, with the majority (53) published between 2005 and 2009. The total number of citations varied from 3354 to 196, and the number of citations per year varied from 9.5 to 129.0 with a median and mean of 30.9 and 38.7, respectively. The majority of publications had a study patients sample size of 200 patients or less. The USA and Germany were the nations with the highest number of frequently cited publications. This bibliometric analysis provides insights on the most-cited articles published on the subject of cardiac CT and calcium volume, thus helping to characterize the field and guide future research., (Copyright © 2016 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
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266. Coronary computed tomography angiography and calcium scoring in routine clinical practice for identification of patients who require revascularization.
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Urbonaviciene G, Isaksen C, Urbonavicius S, Buhl JS, Johansen JK, Nielsen AH, Nørgaard KS, Nørgaard A, and Frost L
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- Aged, Area Under Curve, Coronary Artery Disease mortality, Denmark, Female, Humans, Logistic Models, Male, Middle Aged, Multivariate Analysis, Observer Variation, Odds Ratio, Patient Selection, Predictive Value of Tests, Proportional Hazards Models, ROC Curve, Reproducibility of Results, Risk Factors, Severity of Illness Index, Time Factors, Treatment Outcome, Vascular Calcification mortality, Computed Tomography Angiography, Coronary Angiography methods, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease therapy, Coronary Vessels diagnostic imaging, Multidetector Computed Tomography, Myocardial Revascularization adverse effects, Myocardial Revascularization mortality, Vascular Calcification diagnostic imaging, Vascular Calcification therapy
- Abstract
Background: The predictive value of CCTA to predict coronary artery disease is high in particular in the absence of coronary calcification. However, the consideration of both CCTA and the calcium score, in addition to the risk factors to determine the indication for coronary revascularization, has not been yet studied., Materials and Methods: This study included 2302 patients (mean age: 60±9.8 years, 46% men), without known coronary artery disease (CAD), who underwent 320-row CCTA. Logistic regression, c-statistic and net reclassification improvement (NRI) were used to assess the role of coronary artery calcium score (CACS) in predicting revascularization after CCTA., Results: The revascularization rates were 0.75% in patients with a CACS of 0, and there were no adverse events during the follow-up period. The revascularization rates were 3.3% in patients with a CACS of 1-99, 15.4% in patients with a CACS of 100-399, 25.6% in patients with a CACS of 400-999, and 42.4% in patients with a CACS≥1000. The crude and adjusted odds ratios (95% confidence interval) for revascularization per CACS group category were 2.89 (2.53-2.3) and 2.71 (2.33-3.15), respectively; the area under the ROC curve (AUC) was 0.85 (0.83-0.88). The addition of CACS to conventional risk factors improved the accuracy of risk prediction model for revascularization (AUC 0.74 vs 0.63, P=0.001), but it did not reclassify a substantial proportion of patients with positive CACS to risk categories (NRI=-0.023, P=0.66)., Conclusions: The 320-row CCTA might rule out CAD in low- to intermediate-risk patients. However, its accuracy in identifying patients who require revascularization is limited. The CACS added to the conventional risk factors did not improve the identification of patients who require revascularization., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)
- Published
- 2016
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267. The prognostic value of CT coronary angiography in patients attending hospital with troponin-negative acute chest pain and inconclusive exercise treadmill tests.
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Mordi I and Tzemos N
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- Acute Coronary Syndrome blood, Acute Coronary Syndrome complications, Biomarkers blood, Chest Pain blood, Chest Pain etiology, Female, Humans, Inpatients, Male, Middle Aged, Predictive Value of Tests, Prognosis, Risk Factors, Sensitivity and Specificity, Acute Coronary Syndrome diagnosis, Chest Pain diagnostic imaging, Coronary Angiography methods, Exercise Test, Tomography, X-Ray Computed methods, Troponin blood
- Abstract
Aims: Once acute coronary syndrome (ACS) is excluded in patients presenting to hospital with acute chest pain, usual practice is to stratify future risk of adverse cardiovascular events. Commonly this is performed by pre-discharge exercise treadmill testing (ETT). Often however, patients are unable to perform the test for various reasons, or the final result is inconclusive. This potentially could lead to uncertainty and to unnecessary invasive coronary angiography. We wished to evaluate the potential prognostic significance of CT coronary angiography (CTCA) in patients with prior inconclusive ETTs., Methods and Results: Two hundred and thirty-two consecutive patients underwent CTCA and calcium scoring following hospital attendance with acute chest pain and following exclusion of ACS. All patients were followed up for a combined primary outcome of death, non-fatal myocardial infarction, and late revascularization. The mean follow-up period was 2.5 ± 0.9 years. The combined primary outcome occurred in 26 patients (11.2%). Calcium score (HR 1.16; 95% CI 1.02-1.31, P = 0.023 per 100 Agatston unit increase), the presence of coronary artery disease (CAD) on CTCA (non-obstructive CAD, HR 4.52; 95% CI 1.30-15.73, P = 0.018; obstructive CAD, HR 17.00; 95% CI 4.60-62.85, P < 0.001), and ≥3 segments with non-calcified plaque (HR 3.30; 95% CI 1.24-8.76, P = 0.017) were significant univariable predictors of the primary outcome. CTCA was the only significant multivariable predictor of adverse outcome., Conclusions: The presence of CAD assessed by CTCA is a strong predictor of adverse events in patients with troponin-negative acute chest pain and could potentially be used as an alternative, non-invasive risk stratifier in patients with inconclusive exercise tests., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.)
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- 2016
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268. Technical feasibility and validation of a coronary artery calcium scoring system using CT coronary angiography images.
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Pavitt CW, Harron K, Lindsay AC, Zielke S, Ray R, Gordon D, Rubens MB, Padley SP, and Nicol ED
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- Aged, Coronary Angiography methods, Coronary Vessels diagnostic imaging, Feasibility Studies, Female, Humans, Male, Multidetector Computed Tomography methods, Observer Variation, Radiation Dosage, Reproducibility of Results, Coronary Disease diagnostic imaging, Vascular Calcification diagnostic imaging
- Abstract
Objectives: We validate a novel CT coronary angiography (CCTA) coronary calcium scoring system., Methods: Calcium was quantified on CCTA images using a new patient-specific attenuation threshold: mean + 2SD of intra-coronary contrast density (HU). Using 335 patient data sets a conversion factor (CF) for predicting CACS from CCTA scores (CCTAS) was derived and validated in a separate cohort (n = 168). Bland-Altman analysis and weighted kappa for MESA centiles and Agatston risk groupings were calculated., Results: Multivariable linear regression yielded a CF: CACS = (1.185 × CCTAS) + (0.002 × CCTAS × attenuation threshold). When applied to CCTA data sets there was excellent correlation (r = 0.95; p < 0.0001) and agreement (mean difference -10.4 [95% limits of agreement -258.9 to 238.1]) with traditional calcium scores. Agreement was better for calcium scores below 500; however, MESA percentile agreement was better for high risk patients. Risk stratification was excellent (Agatston groups k = 0.88 and MESA centiles k = 0.91). Eliminating the dedicated CACS scan decreased patient radiation exposure by approximately one-third., Conclusion: CCTA calcium scores can accurately predict CACS using a simple, individualized, semiautomated approach reducing acquisition time and radiation exposure when evaluating patients for CAD. This method is not affected by the ROI location, imaging protocol, or tube voltage strengthening its clinical applicability., Key Points: • Coronary calcium scores can be reliably determined on contrast-enhanced cardiac CT • This score can accurately risk stratify patients • Elimination of a dedicated calcium scan reduces patient radiation by a third.
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- 2016
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269. Application of a Novel CT-Based Iliac Artery Calcification Scoring System for Predicting Renal Transplant Outcomes.
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Davis B, Marin D, Hurwitz LM, Ronald J, Ellis MJ, Ravindra KV, Collins BH, and Kim CY
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- Adult, Aged, Female, Humans, Kidney Failure, Chronic complications, Male, Middle Aged, Prognosis, Retrospective Studies, Severity of Illness Index, Tomography, X-Ray Computed, Treatment Outcome, Vascular Calcification complications, Graft Survival, Iliac Artery diagnostic imaging, Kidney Failure, Chronic therapy, Kidney Transplantation, Vascular Calcification diagnostic imaging
- Abstract
Objective: The objective of our study was to assess whether the degree and distribution of iliac artery calcifications as determined by a CT-based calcium scoring system correlates with outcomes after renal transplant., Materials and Methods: A retrospective review of renal transplant recipients who underwent CT of the pelvis within 2 years before surgery yielded 131 patients: 75 men and 56 women with a mean age of 52 years. Three radiologists assigned a separate semiquantitative score for calcification length, circumferential involvement, and morphology for the common iliac arteries and for the external iliac arteries. The operative and clinical notes were reviewed to determine which iliac arterial segment was used for anastomosis, the complexity of the operation, and whether delayed graft function (DGF) occurred. Renal allograft survival and patient survival were calculated using the Kaplan-Meier technique., Results: Excellent interobserver agreement was noted for each calcification score category. The common iliac arteries showed significantly higher average calcification scores than the external iliac arteries for all categories. Advanced age and diabetes mellitus were independently predictive of higher scores in each category, whereas hypertension, cigarette smoking, hyperlipidemia, and sex were not. Based on multivariate analysis, only the calcification morphology score of the arterial segment used for anastomosis was independently predictive of a higher rate of surgical complexity and of DGF. None of the scores was predictive of graft or patient survival. However, patients with CT evidence of iliac arterial calcification had a lower 1-year survival after transplant than those who did not (92% vs 98%, respectively; p = 0.05)., Conclusion: Only the calcification morphology score of the arterial segment used for anastomosis was significantly predictive of surgical complexity and of DGF. Routine pretransplant CT for calcification scoring in patients of advanced age or those with diabetes mellitus may enable selection of the optimal artery for anastomosis to optimize outcomes.
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- 2016
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270. Association of aortic root calcification severity with the extent of coronary artery calcification assessed by calcium-scoring dual-source computed tomography.
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Hu X, Frellesen C, Kerl JM, Bauer RW, Beeres M, Bodelle B, Lehnert T, Vogl TJ, and Wichmann JL
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- Aged, Aortic Diseases complications, Aortography methods, Coronary Angiography methods, Coronary Artery Disease complications, Female, Humans, Image Processing, Computer-Assisted methods, Imaging, Three-Dimensional methods, Male, Middle Aged, Retrospective Studies, Vascular Calcification complications, Aortic Diseases diagnostic imaging, Calcium analysis, Coronary Artery Disease diagnostic imaging, Tomography, X-Ray Computed methods, Vascular Calcification diagnostic imaging
- Abstract
Purpose: To investigate the association between aortic root calcification (ARC) and coronary artery calcification (CAC) assessed by coronary artery calcium-scoring dual-source computed tomography (DSCT)., Materials and Methods: We retrospectively analyzed 143 consecutive patients who underwent coronary artery calcium-scoring during coronary DSCT angiography. 57 patients had findings of ARC on calcium-scoring scans. ARC volume (ARCV) and Agatston coronary artery calcium score (CACS) were calculated. Chi-square test was used to assess differences of categorical variables between patients with and without ARC. Statistical significances between both groups were assessed with the independent-Sample t test., Results: Compared with patients without ARC (n=86), patients with ARC (n=57) showed a significantly higher presence of CAC (87.7% vs. 24.4%; P<0.001), and a higher mean CACS (700.6 ± 941.2 vs. 256.4 ± 724.3; P=0.009) in patients with CAC. Patients with a calculated ARCV > 40 mm(3) (n=32) showed significantly higher rates of severe CAC (56.3% vs. 24.0%; P=0.014) compared with patients with an ARCV< 40 mm(3) (n=25). Compared with patients without CAC (n=42), patients with CAC (n=101) showed a significantly higher presence of ARC (83.3% vs. 50.5%; P<0.001) and a higher mean ARCV (95.4 ± 116.2mm(3) vs. 29.7 ± 33.0 mm(3); P=0.003). Severe CAC (n=24) correlated with an increased mean ARCV (122.3 ± 148.8mm(3)) compared to patients with minimal to moderate CAC (n=33, mean ARCV: 61.9 ± 64.8mm(3); P<0.05)., Conclusions: The extent of ARC is directly associated with the presence and degree of CAC on calcium-scoring scans during coronary DSCT angiography., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2015
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271. Relationship between breast arterial calcification on mammography with CT Calcium scoring and coronary CT angiography results.
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Moradi M, Adibi A, and Abedi M
- Abstract
Background: Mammography as a non invasive method has been suggested to be helpful in predicting coronary artery disease. This study aimed to investigate whether presence and severity of breast artery calcification (BAC) on mammograms is associated with computed tomography coronary angiography (CTCA) finding such as coronary artery calcium (CAC) score and the severity of coronary artery stenosis., Materials and Methods: This cross-sectional study was performed on 150 women aged >40 years who were referred for CTCA. Women who had undergone screening mammography during the first year after CTCA entered the study. CAC score was determined and the severity of coronary artery stenosis was classified into normal, non-significant stenosis, or significant stenosis. Based on the severity of BAC, patients were also grouped into normal, mild, moderate, or severe groups. Then, the correlation between BAC severity and CAC score was determined. Patients with different BAC severity were also compared regarding the relative frequency of different grades of coronary artery stenosis., Results: Mean age of subjects with BAC (n: 35) was significantly higher than patients without BAC (n: 115) (68.03 ± 6.16 versus 54.36 ± 7.63 years, P < 0.0001). Although the relative frequency of different grades of coronary artery stenosis was significantly higher in women with BAC (P < 0.0001), after controlling for age, there was no significant difference between patients with different severity of BAC in the mean of CAC score (P: 0.09). In addition, the correlation between BAC severity and CAC score was not statistically significant (R: 0.09, P: 0.26)., Conclusion: We concluded that presence and severity of BAC have no significant correlation with CAC score on CTCA.
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- 2014
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272. Coronary computed tomographic angiography (CCTA) in community hospitals: "current and emerging role".
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Sharma RK, Voelker DJ, Sharma RK, Singh VN, Bhatt G, Moazazi M, Nash T, and Reddy HK
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- Chest Pain diagnostic imaging, Chest Pain etiology, Coronary Angiography adverse effects, Coronary Artery Disease complications, Humans, Predictive Value of Tests, Prognosis, Quality of Health Care, Triage, Cardiology Service, Hospital organization & administration, Coronary Angiography methods, Coronary Artery Disease diagnostic imaging, Emergency Service, Hospital organization & administration, Hospitals, Community organization & administration, Tomography, X-Ray Computed adverse effects
- Abstract
Coronary computed tomographic angiography (CCTA) is a rapidly evolving test for diagnosis of coronary artery disease. Although invasive coronary angiography is the gold standard for coronary artery disease (CAD), CCTA is an excellent noninvasive tool for evaluation of chest pain. There is ample evidence to support the cost-effective use of CCTA in the early triage process of patients presenting with chest pain in the emergency room. CCTA plays a critical role in the diagnosis of chest pain etiology as one of potentially fatal conditions, aortic dissection, pulmonary embolism, and myocardial infarction. This 'triple rule out' protocol is becoming an increasingly practicable and popular diagnostic tool in ERs across the country. In addition to a quick triage of chest pain patients, it may improve quality of care, decrease cost, and prevent medico-legal risk for missing potentially lethal conditions presenting as chest pain. CCTA is also helpful in the detection of subclinical and vulnerable coronary plaques. The major limitations for wide spread acceptance of this test include radiation exposure, motion artifacts, and its suboptimal imaging with increased body mass index.
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- 2010
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273. Size and nature of emboli produced during carotid artery angioplasty and stenting: In vivo study
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Robert E. Brightwell, M. Hamady, T.A. Ryder, and Nicholas J.W. Cheshire
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Male ,medicine.medical_specialty ,Carotid arteries ,medicine.medical_treatment ,Embolism ,Calcium scoring ,Asymptomatic ,Embolic Protection Devices ,In vivo ,Carotid artery angioplasty ,Angioplasty ,Electron microscopy ,Medicine ,Humans ,Carotid Stenosis ,Computed tomography ,Aged ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Embolisation ,General Medicine ,Middle Aged ,medicine.disease ,Stenosis ,Carotid Arteries ,Angiography ,Microscopy, Electron, Scanning ,Surgery ,Calcium ,Female ,Stents ,Radiology ,medicine.symptom ,business ,Tomography, X-Ray Computed ,Tomography, Spiral Computed ,Carotid artery stenting - Abstract
Aim Microembolization continues to be a major risk for patients undergoing carotid artery stenting (CAS) of high-grade atherosclerotic carotid stenoses. Further insight into the characteristics and significance of these embolized particles was deemed necessary. We aimed to assess the size and composition of debris captured by filters during CAS and to determine if this could be predicted using standard imaging techniques. Methods 20 patients (10 symptomatic, 15 men, mean age 64.6 years) undergoing CAS for high-grade ICA stenosis were recruited. All underwent pre-operative CT angiography and calcium scoring. All underwent CAS using the same protocol. A filter-type embolic protection device (EPD) was used and retrieved post-operatively and captured particles underwent analysis using a Scanning Electron Microscope (SEM) for counting, sizing, and composition. Results Clinical. Debris was found on 100% of filters when analysed with SEM. There were non-significant trends for CAS in asymptomatic patients to produce a greater number of smaller, calcified particles while in symptomatic patients we observed larger, lipid-rich particles. When stratified according to pre-operative calcium scores, ‘calcium-rich' plaques produced significantly greater numbers of emboli captured on the EPD ( p = 0.02). Conclusions Filter-type EPDs collect debris of significant quantity and size during the CAS procedure as performed in our institution. The collected material was likely dislocated from the atherosclerotic plaque. CT calcium scoring allows us to predict the nature of material captured by the EPD. These data may allow the clinician to individualise care during CAS and thus reduce peri-operative risk.
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274. An Ounce of Prevention With a Calcium Score Scan?⁎⁎Editorials published in JACC: Cardiovascular Imaging reflect the views of the authors and do not necessarily represent the views of JACC: Cardiovascular Imaging or the American College of Cardiology
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Garcia, Mario J. and Fuster, Valentin
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calcium scoring ,Radiology Nuclear Medicine and imaging ,computed tomography ,Cardiology and Cardiovascular Medicine ,coronary artery disease - Full Text
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275. Low Radiation Dose Calcium Scoring: Evidence and Techniques
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Marcus Y. Chen, Andrew D. Choi, and Kaitlin Baron
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medicine.medical_specialty ,Histology ,030204 cardiovascular system & hematology ,Coronary artery disease ,Applied Microbiology and Biotechnology ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Iterative Reconstruction ,Internal medicine ,Coronary artery calcium (CAC) scoring ,medicine ,Low dose ct ,cardiovascular diseases ,Cardiac Computed Tomography (TC Villines, Section Editor) ,Cardiac risk ,Computed tomography (CT) ,medicine.diagnostic_test ,business.industry ,Atherosclerotic cardiovascular disease ,Ultrasound ,nutritional and metabolic diseases ,Interventional radiology ,Cell Biology ,Rescan variability ,medicine.disease ,Coronary arteries ,medicine.anatomical_structure ,Calcium scoring ,cardiovascular system ,Cardiology ,Low dose radiation ,Radiology ,Atherosclerotic cardiovascular disease (ASCVD) ,business - Abstract
Coronary computed tomography (CT) allows for the acquisition of thin slices of the heart and coronary arteries, which can be used to detect and quantify coronary artery calcium (CAC), a marker of atherosclerotic cardiovascular disease. Despite the proven clinical value in cardiac risk prognostication, there remain concerns regarding radiation exposure from CAC CT scans. There have been several recent technical advancements that allow for significant radiation dose reduction in CAC scoring. This paper reviews the clinical utility and recent literature in low radiation dose CAC scoring.
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276. [Untitled]
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Aortic valve ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Hemodynamics ,030204 cardiovascular system & hematology ,Doppler echocardiography ,medicine.disease ,03 medical and health sciences ,Stenosis ,0302 clinical medicine ,medicine.anatomical_structure ,Calcium scoring ,Calcinosis ,Internal medicine ,Aortic valve stenosis ,medicine ,Cardiology ,030212 general & internal medicine ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Calcification - Abstract
The evaluation of aortic stenosis (AS) severity is routinely performed using echocardiography. Current guidelines recommend integrating data with respect to the peak aortic valve jet velocity, the mean transvalvular gradient and the aortic valve area (AVA) calculated by the continuity equation.1 For the majority of patients this assessment works well. However in a third of subjects there is discrepancy in the results provided by these different measures.2 Most commonly this takes the form of an AVA
277. INTERMEDIATE RISK PATIENTS WITH RENAL INSUFFICIENCY HAVE MORE CALCIFIED CORONARY ARTERY LESIONS, MORE DISTAL LESION DISTRIBUTIONS, AND LONGER/WIDER LESION GEOMETRIES BY LESION SPECIFIC CALCIUM SCORING
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Reynaria Pitts, Parag H. Joshi, Wassim Odeh, Kunal Bhatt, Zhen Qian, Nancy Flockhart, Sarah Rinehart, Viju Varghese, Szilard Voros, Joseph B Miller Md, and James Chun-I Lee
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medicine.medical_specialty ,business.industry ,Lesion ,medicine.anatomical_structure ,Calcium scoring ,Internal medicine ,medicine ,Cardiology ,Radiology ,medicine.symptom ,Intermediate risk ,business ,Cardiology and Cardiovascular Medicine ,Artery - Full Text
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