Comparison of artery-based methods for ordinal grading of coronary artery calcium on low-dose chest computed tomography

医学 神经组阅片室 放射科 冠状动脉疾病 介入放射学 超声波 分级(工程) 计算机断层血管造影 计算机断层摄影术 心脏病学 冠状动脉钙 心脏成像 神经学 精神科 工程类 土木工程
作者
Suji Lee,Young Joo Suh,Kyungsun Nam,Kye Ho Lee,Hye‐Jeong Lee,Byoung Wook Choi
出处
期刊:European Radiology [Springer Science+Business Media]
卷期号:31 (11): 8108-8115 被引量:6
标识
DOI:10.1007/s00330-021-07987-7
摘要

To identify the optimal artery-based method for ordinal grading of coronary artery calcium (CAC) on non-electrocardiogram (ECG)-gated low-dose chest computed tomography (LDCT) among three methods.A total of 120 asymptomatic subjects who underwent both LDCT and ECG-gated calcium scoring CT on the same day were retrospectively enrolled. Three cardiothoracic radiologists independently assessed CAC severity on LDCT (1.25-mm and 2.5-mm slice thickness) and classified it into four categories (none, mild, moderate, or severe) using three artery-based ordinal scoring methods (extent-based scoring, Weston scoring, and length-based scoring). Inter- and intra-observer CAC severity agreements of each method were assessed by Fleiss kappa statistics. Agreements between each method and ECG-gated calcium scoring CT were assessed by weighted kappa statistics.The inter-observer agreement was highest with length-based method for both 1.25-mm (Fleiss kappa 0.735 for extent-based method, 0.801 for Weston score, and 0.813 for length-based method) and 2.5-mm slice thickness evaluation (Fleiss kappa 0.755 for extent-based method, 0.776 for Weston score, and 0.833 for extent-based method). Agreement across the three grading methods for the same observer was poor to moderate on 1.25-mm (Fleiss kappa 0.379-0.441) and moderate on 2.5-mm thickness evaluation (Fleiss kappa 0.427-0.461). Agreement of CAC severity between each method and ECG-gated calcium scoring CT was highest with the length-based method for all three observers on both 1.25-mm (weighted kappa 0.773-0.786) and 2.5-mm (weighted kappa 0.794-0.825) LDCT images.Among the three artery-based ordinal grading methods, the length-based method appears to be the most reliable for evaluating CAC on non-ECG-gated LDCT.• The length-based method showed the highest inter-observer agreement and the highest agreement with the ECG-gated calcium scoring CT, compared with the extent-based method and the Weston score.
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