Reproducibility of coronary plaque detection and characterization using low radiation dose coronary computed tomographic angiography in patients with intermediate likelihood of coronary artery disease (ReSCAN study)

Int J Cardiovasc Imaging. 2012 Apr;28(4):889-99. doi: 10.1007/s10554-011-9895-1. Epub 2011 May 29.


The purpose of this study is to evaluate the interscan, interobserver and intraobserver agreement for coronary plaque detection, and characterization using low radiation dose high-pitch spiral acquisition coronary CT angiography (CTA). Two experienced observers independently evaluated coronary CTA datasets from 50 consecutive patients undergoing two 128-slice dual source CT scans within 12 days. Mean (±SD) estimated radiation exposure was 1.5 ± 0.2 mSv per scan. Observers recorded the presence and characterization of coronary plaques as non-calcified or calcified. A "segment involvement score" (SIS) was computed by summing the numbers of segments with any coronary plaque per patient. Reproducibility was assessed using kappa (κ) statistics, paired t test and Bland-Altman analyses. Interscan, interobserver, and intraobserver agreement (κ-values) for detection of any or calcified plaques were 83-94% (κ-values 0.57-0.85), and 67-84% (0.31-0.67) for non-calcified plaques on a patient level. No significant difference was observed in mean interscan or interobserver SIS. Mean (95% CI) intraobserver SIS difference was -0.88 (-1.25; -0.51), P < 0.001, with limits of agreement from -4.7 to 2.9. Low radiation dose high-pitch coronary CTA permits detection of any or calcified plaques with high interscan, interobserver, intraobserver agreement. However, variability for the detection of non-calcified plaque is substantial.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Body Mass Index
  • Coronary Angiography / methods*
  • Coronary Artery Disease / diagnostic imaging*
  • Coronary Artery Disease / pathology
  • Coronary Vessels / pathology*
  • Denmark
  • Female
  • Heart Rate
  • Humans
  • Male
  • Middle Aged
  • Observer Variation
  • Plaque, Atherosclerotic
  • Predictive Value of Tests
  • Radiation Dosage*
  • Reproducibility of Results
  • Risk Assessment
  • Risk Factors
  • Tomography, Spiral Computed*
  • Vascular Calcification / diagnostic imaging
  • Vascular Calcification / pathology