Abstract
Iterative reconstruction techniques for coronary CT angiography have been introduced as an alternative for traditional filter back projection (FBP) to reduce image noise, allowing improved image quality and a potential for dose reduction. However, the impact of iterative reconstruction on the coronary artery calcium score is not fully known. In 112 consecutive stable patients with suspected coronary artery disease, the coronary calcium scores were assessed. Comparisons were made between the Agatston, volume and mass scores obtained with traditional FBP, and by using adaptive statistical iterative reconstruction (ASIR). A significant reduction of the Agatston score, volume score and mass score was observed for ASIR when compared to FBP, with median differences of resp. 26, 5 mm3 and 1 mg. Using the ASIR reconstruction, the number of patients with a calcium score of zero increased by 13 %. Iterative CT reconstruction significantly reduces the Agatston, volume and mass scores. Since the calcium score is used as a prognostic tool for coronary artery disease, caution must be taken when using iterative reconstruction.
Similar content being viewed by others
Abbreviations
- FBP:
-
Filtered back projection
- IR:
-
Iterative reconstruction
- ASIR:
-
Adaptive statistical iterative reconstruction
- CAC:
-
Coronary artery calcium
- CAD:
-
Coronary artery disease
- CCTA:
-
Coronary CT angiography
References
Simons DB, Schwarz RS, Edwards WD et al (1992) Noninvasive definition of anatomic coronary artery disease by ultrafast computed tomographic scanning: a quantitative pathologic comparison study. J Am Coll Cardiol 20(5):1118–1126
Budoff MJ, Shaw LJ, Liu ST et al (2007) Long-term prognosis associated with coronary calcification: observations from a registry of 25,253 patients. J Am Coll Cardiol 49(18):1860–1870
Shaw LJ, Raggi P, Schisterman E et al (2003) Prognostic value of cardiac risk factors and coronary artery calcium screening for all-cause mortality. Radiology 228(3):826–833
Budoff MJ, Diamond GA, Raggi P et al (2002) Continuous probabilistic prediction of angiographically significant coronary artery disease using electron beam tomography. Circulation 105(15):1791–1796
Sarwar A, Shaw LJ, Shapiro MD et al (2009) Diagnostic and prognostic value of absence of coronary artery calcification. JACC Cardiovasc Imaging 2(6):675–688. Review. Erratum in: JACC Cardiovasc Imaging 2010;3(10):1089. Hoffmann, Udo [corrected to Hoffmann, Udo]
Haberl R, Becker A, Leber A et al (2001) Correlation of coronary calcification and angiographically documented stenosis in patients with coronary artery disease: results of 1,764 patients. J Am Coll Cardiol 37(2):451–457
Knez A, Becker A, Leber A et al (2004) Relation of coronary calcium scores by electron beam tomography to obstructive disease in 2,115 symptomatic patients. Am J Cardiol 93(9):1150–1152
Villines TC, Hulten EA, Shaw LF et al (2011) Prevalence and severity of coronary artery disease and adverse events among symptomatic patients with coronary artery calcification scores of zero undergoing coronary computed tomography angiography results from the CONFIRM (Coronary CT Angiography Evaluation for Clinical Outcomes: an International Multicenter) Registry. J Am Coll Cardiol 58(24):2533–2540
Mouden M, Timmer JR, Reiffers S et al (2013) Coronary artery calcium scoring to exclude flow-limiting coronary artery disease in symptomatic stable patients at low or intermediate risk. Radiology [Epub ahead of print], PMID:23788718
Hecht HS (2011) Controversies in nuclear cardiology: CT calcium scoring should be routinely performed in patients undergoing myocardial perfusion imaging who have a normal test result (and should be routinely performed before myocardial perfusion imaging)–pro. J Nucl Cardiol 18:695–699
Thompson RC, McGhie AI, Moser KW et al (2005) Clinical utility of coronary calcium scoring after nonischemic myocardial perfusion imaging. J Nucl Cardiol 12:392–400
Bybee KA, Lee J, Markiewicz R et al (2010) Diagnostic and clinical benefit of combined coronary calcium and perfusion assessment in patients undergoing PET/CT myocardial stress perfusion imaging. J Nucl Cardiol 17:188–196
Fazel R, Krumholz HM, Yongfei Wang SM et al (2009) Exposure to low-dose ionizing radiation from medical imaging procedures. N Engl J Med 361:849–857
Moscariello A, Takx RA, Schoepf UJ et al (2011) Coronary CT angiography: image quality, diagnostic accuracy, and potential for radiation dose reduction using a novel iterative image reconstruction technique-comparison with traditional filtered back projection. Eur Radiol 21(10):2130–2138
Utsunomiya D, Weigold WG, Weissman G et al (2012) Effect of hybrid iterative reconstruction technique on quantitative and qualitative image analysis at 256-slice prospective gating cardiac CT. Eur Radiol 22(6):1287–1294
Renker M, Ramachandra A, Schoepf JU (2011) Iterative image reconstruction techniques: applications for cardiac CT. J Cardiovasc Comput Tomogr 5(4):225–230
Renker M, Nance JW, Schoepf UJ (2011) Evaluation of heavily calcified vessels with coronary CT angiography: comparison of iterative and filtered back projection image reconstruction. Radiology 260(2):390–399
Leipsic J, Heilbron BG, Hague C et al (2012) Iterative reconstruction for coronary CT angiography: finding its way. Int J Cardiovasc Imaging 28(3):613–620
Ebersberger U, Tricarico F, Schoepf UJ et al (2012) CT evaluation of coronary artery stents with iterative image reconstruction: improvements in image quality and potential for radiation dose reduction. Eur Radiol 31:125–132. doi:10.1007/s00330-012-2580-5
Murazaki H, Funama Y, Hatemura M et al (2011) Quantitative evaluation of calcium (content) in the coronary artery using hybrid iterative reconstruction (iDose) algorithm on low-dose 64-detector CT: comparison of iDose and filtered back projection. Nihon Hoshasen Gijutsu Gakkai Zasshi 67(4):360–366 (printed in Japanese)
Funabashi N, Irie R, Aiba M et al (2013) Adaptive-iterative-dose-reduction 3D with multisector-reconstruction method in 320-slice CT may maintain accurate-measurement of the Agatston-calcium-score of severe-calcification even at higher pulsating-beats and low tube-current in vitro. Int J Cardiol 168(1):601–603
Blobel J, Mews J, Schuijf JD et al (2013) Determining the radiation dose reduction potential for coronary calcium scanning with computed tomography: an anthropomorphic phantom study comparing filtered backprojection and the adaptive iterative dose reduction algorithm for image reconstruction. Invest Radiol 48(12):857–862. doi:10.1097/RLI.0b013e31829e3932
Gebhard C, Fiechter M, Fuchs TA (2012). Coronary artery calcium score influence of adaptive statistical iterative reconstruction using 64 MDCT. Int J Cardiol [Epub ahead of print]
Kurata A, Dharampal A, Dedic A et al (2013). Impact of iterative reconstruction on CT coronary calcium quantification. Eur Radiol. doi:10.1007/s00330-013-3022-8
Diamond GA, Forrester JS (1979) Analysis of probability as an aid in the clinical diagnosis of coronary-artery disease. N Eng J Med 300:1350–1358
Agatston AS, Janowitz WR, Hildner FJ et al (1990) Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 15:827–832
Huda W, Ogden KM, Khorasani MR (2008) Converting dose-length product to effective dose at CT. Radiology 248:995–1003
Budoff MJ, Nasir K, McClelland RL et al (2009) Coronary calcium predicts events better with absolute calcium scores than age–sex–race/ethnicity percentiles. J Am Coll Cardiol 53(4):345–352
Becker CR, Kleffel T, Crispin A (2001) Coronary artery calcium measurement: agreement of multirow detector and electron beam CT. Am J Radiol 176:1295–1298
Thibault JB, Sauer KD, Bouman CA et al (2007) A three-dimensional statistical approach to improved image quality for multislice helical CT. Med Phys 34(11):4526–4544
Richard S, Husarik DB, Yadava G et al (2012). Towards task-based assessment of CT performance: system and object MTF across different reconstruction algorithms. Med Phys 39(7): 4115–4122. doi:10.1118/1.4725171
Willemink MJ, Leiner T, de Jong PA et al (2013) Iterative reconstruction techniques for computed tomography part 2: initial results in dose reduction and image quality. Eur Radiol 23(6):1632–1642
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
van Osch, J.A.C., Mouden, M., van Dalen, J.A. et al. Influence of iterative image reconstruction on CT-based calcium score measurements. Int J Cardiovasc Imaging 30, 961–967 (2014). https://doi.org/10.1007/s10554-014-0409-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10554-014-0409-9