Frequency of unrecognized, unreported, or underreported coronary artery and cardiovascular calcification on noncardiac chest CT

J Cardiovasc Comput Tomogr. May-Jun 2013;7(3):167-72. doi: 10.1016/j.jcct.2013.05.003. Epub 2013 May 31.

Abstract

Background: Coronary artery calcification (CAC) is correlated with cardiovascular outcomes and, therefore, can change management. Such calcifications are identifiable on noncardiac chest CT (NCCT), although there is no standard for interpretation. However, no data are published on the frequency of these findings being reported during NCCT interpretation.

Methods: To obtain population with a high likelihood of CAC, we identified 355 patients with known (n = 136) or suspected (n = 219) coronary artery disease in whom single-photon emission CT myocardial perfusion imaging and NCCT were ordered within 1 month of each other; their mean age was 63 years, and 204 were women. Single-photon emission CT reports, NCCT reports, and retrospective NCCT image interpretations were performed by the investigators independently.

Results: CAC was present in 207 of the 355 patients (58% of the group) but was recorded in the final radiology report as present in only 44% of these subjects. CAC in the left main coronary artery was evident on review in 139 patients but was specified in the final report in only 1 patient. Left anterior descending CAC was evident in 188 patients but reported in only 3%.

Conclusions: In this observational study, CAC on NCCT in this enriched population was often unreported. Although NCCT can indicate presence and location of CAC, these features are rarely reported, even when involving locations such as the left main coronary artery or left anterior descending artery. In view of its diagnostic and prognostic importance, evaluation of CAC should become a routine part of the interpretation of NCCT.

Keywords: Chest computed tomography; Coronary calcification; Valvular calcification; Vascular calcification.

MeSH terms

  • Calcinosis / diagnostic imaging*
  • Cardiac-Gated Imaging Techniques
  • Chi-Square Distribution
  • Contrast Media
  • Coronary Artery Disease / diagnostic imaging*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Perfusion Imaging
  • Radiography, Thoracic*
  • Retrospective Studies
  • Sensitivity and Specificity
  • Tomography, Emission-Computed, Single-Photon
  • Tomography, X-Ray Computed / methods*

Substances

  • Contrast Media