Key result
100-kV CAC scanning with modified thresholds yields scores comparable to standard 120-kV scanning.
Why the study?
The study aimed to determine the proper modified thresholds for detecting and weighting coronary artery calcium scores at 100 kV through histogram matching compared with standard 120 kV.
Does CAC scoring at 100 kV with modified thresholds provide accurate scores compared to 120 kV while reducing radiation dose?
Observational (n=893)
No
Does CAC scoring at 100 kV with modified thresholds provide accurate scores compared to 120 kV while reducing radiation dose?
Mean Difference: 0.74 (95% CI -52.35–53.83)
Absolute Event Rate: 17.3% vs 18.7%
p-value: p=0.689
Histogram-derived modified thresholds at 100 kV enable accurate CAC scoring with significantly reduced radiation exposure compared to standard 120 kV scanning.
We aimed to determine the proper modified thresholds for detecting and weighting CAC scores at 100 kV through histogram matching in comparison with 120 kV as a standard reference. From the training set (680 participants), modified thresholds at 100 kV were obtained through histogram matching of calcium pixels to 120 kV. From the validation set (213 participants), a standard CAC score at 120 kV, and modified CAC score at 100 kV using modified thresholds were compare through the paired t test and the Bland-Altman plot. Agreement for risk categories (no, minimal, mild, moderate, and severe) was evaluated using kappa statistics. Radiation doses were also compared. For the validation set, there was no significant difference between standard (median, 18.7; IQR, 0.0-207.0) and modified (median, 17.3; IQR, 0.0-220.9) CAC scores (P = 0.689). A small bias was achieved (0.74) with 95% limits of agreement from - 52.35 to 53.83. Agreements for risk categories were excellent (κ = 0.994). The mean dose-length-product of 100-kV scanning (30.1 ± 0.8 mGy * cm) was significantly decreased compared to 120-kV scanning (42.9 ± 0.6 mGy * cm) (P < 0.001). Histogram-derived modified thresholds at 100 kV can enable accurate CAC scoring while reducing radiation exposure.
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Kim et al. (2021) conducted an observational in Coronary artery calcification (n=893). 100 kV CAC scanning with modified thresholds vs. 120 kV CAC scanning was evaluated on Coronary artery calcium (CAC) score in the validation set (bias 0.74, 95% CI -52.35 to 53.83, p=0.689). 100-kV coronary artery calcium scanning with modified thresholds yielded scores comparable to standard 120-kV scanning (median 17.3 vs 18.7, P=0.689) with a small bias of 0.74.
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