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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

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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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Acknowledgement

This study was supported by the German Government, Bundesministerium für Bildung und Forschung (01EX1012B, “Spitzencluster Medical Valley”).

Author information

Authors and Affiliations

  1. Department of Cardiology, University of Giessen, Giessen, Germany

    Annika Schuhbäck, Johannes Rixe & Christian Hamm

  2. Department of Cardiology, University of Erlangen, Ulmenweg 18, 91054, Erlangen, Germany

    Mohamed Marwan, Sören Gauss, Gerd Muschiol, Dieter Ropers, Werner G. Daniel & Stephan Achenbach

  3. Department of Radiology, University of Giessen, Giessen, Germany

    Christian Schneider

  4. Department of Radiology, University of Erlangen, Erlangen, Germany

    Michael Lell

Authors
  1. Annika Schuhbäck
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Correspondence to Stephan Achenbach.

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Schuhbäck, A., Marwan, M., Gauss, S. et al. 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. Eur Radiol 22, 1529–1536 (2012). https://doi.org/10.1007/s00330-012-2389-2

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  • DOI: https://doi.org/10.1007/s00330-012-2389-2

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