Department of Radiology and Radiological Science, Division of Cardiology, Medical University of South Carolina, 25 Courtenay Dr, MSC 226, Charleston, SC 29425, USA.
Radiology. 2012 Oct;265(1):70-7. doi: 10.1148/radiol.12112532. Epub 2012 Jul 6.
To investigate whether coronary artery calcium (CAC) scoring performed on three different workstations generates comparable and thus vendor-independent results.
Institutional review board and Federal Office for Radiation Protection approval were received, as was each patient's written informed consent. Fifty-nine patients (37 men, 22 women; mean age, 57 years±3 [standard deviation]) underwent CAC scoring with use of 64-section multidetector computed tomography (CT) with retrospective electrocardiographic gating (one examination per patient). Data sets were created at 10% increments of the R-R interval from 40%-80%. Two experienced observers in consensus calculated Agatston and volume scores for all data sets by using the calcium scoring software of three different workstations. Comparative analysis of CAC scores between the workstations was performed by using regression analysis, Spearman rank correlation (rs), and the Kruskal-Wallis test.
Each workstation produced different absolute numeric results for Agatston and volume scores. However, statistical analysis revealed excellent correlation between the workstations, with highest correlation at 60% of the R-R interval (minimal rs=0.998; maximal rs=0.999) for both scoring methods. No significant differences were detected for Agatston and volume score results between the software platforms. At analysis of individual reconstruction intervals, each workstation demonstrated the same score variability, with the consequence that 12 of 59 patients were assigned to divergent cardiac risk groups by using at least one of the workstations.
While mere numeric values might be different, commercially available software platforms produce comparable CAC scoring results, which suggests a vendor-independence of the method; however, none of the analyzed software platforms appears to provide a distinct advantage for risk stratification, as the variability of CAC scores depending on the reconstruction interval persists across platforms.
研究在三种不同工作站上进行冠状动脉钙化（CAC）评分是否能产生可比的、因此与供应商无关的结果。
获得了机构审查委员会和联邦辐射防护办公室的批准，以及每位患者的书面知情同意。59 名患者（37 名男性，22 名女性；平均年龄 57 岁±3[标准差]）接受了使用 64 层多排螺旋 CT（CT）进行的 CAC 评分，采用回顾性心电图门控（每位患者一次检查）。数据集在 R-R 间隔的 40%-80%以 10%的增量创建。两名经验丰富的观察者在共识的基础上，使用三种不同工作站的钙评分软件计算了所有数据集的 Agatston 和体积评分。通过回归分析、Spearman 秩相关系数(rs)和 Kruskal-Wallis 检验对工作站之间的 CAC 评分进行了比较分析。
每个工作站对 Agatston 和体积评分产生了不同的绝对数值结果。然而，统计分析显示工作站之间具有极好的相关性，两种评分方法在 R-R 间隔的 60%时相关性最高（最小 rs=0.998；最大 rs=0.999）。在软件平台之间未检测到 Agatston 和体积评分结果的显著差异。在分析个体重建间隔时，每个工作站都表现出相同的评分变异性，结果是，使用至少一个工作站将 59 名患者中的 12 名分配到不同的心脏风险组。
虽然数值可能不同，但商业上可用的软件平台可产生可比的 CAC 评分结果，这表明该方法与供应商无关；然而，在所分析的软件平台中，没有一个平台似乎在风险分层方面具有明显优势，因为 CAC 评分的变异性取决于重建间隔，这在不同平台上都存在。
