Comparison of artery-based methods for ordinal grading of coronary artery calcium on low-dose chest computed tomography
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작성일 21-04-22 11:48
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Abstract
Objectives
To identify the optimal artery-based method for ordinal grading of coronary artery calcium (CAC) on non-electrocardiogram (ECG)-gated low-dose chest computed tomography (LDCT) among three methods.
Methods
A total of 120 asymptomatic subjects who underwent both LDCT and ECG-gated calcium scoring CT on the same day were retrospectively enrolled. Three cardiothoracic radiologists independently assessed CAC severity on LDCT (1.25-mm and 2.5-mm slice thickness) and classified it into four categories (none, mild, moderate, or severe) using three artery-based ordinal scoring methods (extent-based scoring, Weston scoring, and length-based scoring). Inter- and intra-observer CAC severity agreements of each method were assessed by Fleiss kappa statistics. Agreements between each method and ECG-gated calcium scoring CT were assessed by weighted kappa statistics.
Results
The inter-observer agreement was highest with length-based method for both 1.25-mm (Fleiss kappa 0.735 for extent-based method, 0.801 for Weston score, and 0.813 for length-based method) and 2.5-mm slice thickness evaluation (Fleiss kappa 0.755 for extent-based method, 0.776 for Weston score, and 0.833 for extent-based method). Agreement across the three grading methods for the same observer was poor to moderate on 1.25-mm (Fleiss kappa 0.379–0.441) and moderate on 2.5-mm thickness evaluation (Fleiss kappa 0.427–0.461). Agreement of CAC severity between each method and ECG-gated calcium scoring CT was highest with the length-based method for all three observers on both 1.25-mm (weighted kappa 0.773–0.786) and 2.5-mm (weighted kappa 0.794–0.825) LDCT images.
Conclusion
Among the three artery-based ordinal grading methods, the length-based method appears to be the most reliable for evaluating CAC on non-ECG-gated LDCT.
Key Points
• The length-based method showed the highest inter-observer agreement and the highest agreement with the ECG-gated calcium scoring CT, compared with the extent-based method and the Weston score.
Journal: European Radiology
Author
Suji Lee, Young Joo Suh, Kyungsun Nam, Kyeho Lee, Hye-Jeong Lee, and Byoung Wook Choi
DOI: doi.org/10.1007/s00330-021-07987-7
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이전글
Use of Artificial Intelligence-Based Software as Medical Devices for Chest Radiography: A Position Paper from the Korean Society of Thoracic Radiology -
다음글
Evaluation of the Ostium in Anomalous Origin of the Right Coronary Artery with an Interarterial Course Using Dynamic Cardiac CT and Implications of Ostial Findings