Spiral versus electron-beam CT for coronary artery calcium scoring

Radiology. 2001 Oct;221(1):213-21. doi: 10.1148/radiol.2211001038.


Purpose: To determine differences in coronary artery calcium detection, quantification, and reproducibility, as measured at electron-beam computed tomography (CT) and subsecond spiral CT with retrospective electrocardiogram gating in an asymptomatic adult population.

Materials and methods: Seventy subjects asymptomatic for coronary heart disease underwent both electron-beam CT and subsecond spiral CT. In all subjects, two images each were obtained with both scanners. Two experienced readers using three different algorithms scored each of the four scans: one score for the electron-beam CT images and two scores for the spiral CT images.

Results: With a 130-HU threshold for the quantification of calcium, there were no significant differences in interscan and interobserver variation in calcium scores between the electron-beam CT and spiral CT images. There was greater interobserver (P <.001) and interscan (P <.03) variation in scores when a 90-HU threshold was used for spiral CT images. With a 130-HU threshold, when calcium scores were used for clinical risk stratification, there was a significant difference between the results obtained with electron-beam CT and those obtained with spiral CT (P <.05).

Conclusion: Spiral CT has not yet proved to be a feasible alternative to electron-beam CT for coronary artery calcium quantification. There are systematic differences between calcium scores obtained with single-detector array subsecond spiral CT and those obtained with electron-beam CT.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Calcium / analysis*
  • Coronary Angiography / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Observer Variation
  • Reproducibility of Results
  • Retrospective Studies
  • Risk Assessment
  • Tomography, X-Ray Computed / methods*


  • Calcium