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Interobserver Agreement for the Detection of Atherosclerotic Plaque in Coronary CT Angiography: Comparison of Two Low-dose Image Acquisition Protocols with Standard Retrospectively ECG-gated Reconstruction

Overview

Overview

Journal Eur Radiol

Specialty Radiology

Date 2012 Jun 5

PMID 22661076

Citations 4

Authors

Authors

Annika Schuhback

Mohamed Marwan

Soren Gauss

Gerd Muschiol

Dieter Ropers

Christian Schneider

Michael Lell

Johannes Rixe

Christian Hamm

Werner G Daniel

Stephan Achenbach

Affiliations

Affiliations

Soon will be listed here.

Abstract

Background: We compared the interobserver variability concerning the detection of calcified and non-calcified plaque in two different low-dose and standard retrospectively gated protocols for coronary CTA.

Methods: 150 patients with low heart rates and less than 100 kg body weight were randomised and examined by contrast-enhanced dual-source CT coronary angiography (100 kV, 320 mAs). 50 patients were examined with prospectively ECG-triggered axial acquisition, 50 patients with prospectively ECG-triggered high pitch spiral acquisition, and 50 patients using spiral acquisition with retrospective ECG gating. Two investigators independently analysed the datasets concerning the presence of calcified and non-calcified plaque on a per-segment level.

Results: Mean effective dose was 1.4 ± 0.2 mSv for axial, 0.8 ± 0.07 mSv for high-pitch spiral, and 5.3 ± 2.6 mSV for standard spiral acquisition (P < 0.0001). In axial acquisition, interobserver agreement concerning the presence of atherosclerotic plaque was achieved in 650/749 coronary segments (86.8%). In high-pitch spiral acquisition, agreement was achieved in 664/748 segments (88.8%, n.s.). In standard spiral acquisition, agreement was achieved in 672/738 segments (91.0%, P < 0.0001). Interobserver agreement was significantly higher for calcified than for non-calcified plaque in all data acquisition modes.

Conclusion: Low-dose coronary CT angiography permits the detection of coronary atherosclerotic plaque with good interobserver agreement.

Key Points: • Low-dose CT protocols permit coronary plaque detection with good interobserver agreement. • Image noise is a major predictor of interobserver variability. • Interobserver agreement is significantly higher for calcified than for non-calcified plaque.

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