Aim and Objective:
To estimate the relationship between Coronary Calcium Scoring (CCS)and presence of
different degrees of obstructive coronary artery disease (CAD) to avoid unnecessary examinations and hence unnecessary
radiation exposure and contrast injection.
Background:
Coronary Calcium Scoring (CCS) is a test uses x-ray equipment to produce pictures of the coronary arteries
to determine the degree of its narrowing by the build-up of calcified plaques. Despite the lack of definitive data linking
ionizing radiation with cancer, the American Heart Association supports widely that practitioners of Computed
tomography Coronary Angiography (CTCA) should keep “patient radiation doses as low as reasonably achievable but
consistent with obtaining the desired medical information”.
Methods:
Data obtained from 275 CTCA examinations were reviewed. Radiation effective doses were estimated for both
CCS and CTCA, measures to keep it as low as possible were presented, CCS and Framingham risk estimate were
compared to the final results of CTCA to detect sensitivity and specificity of each one in detecting obstructive lesions.
Results:
CCS is a strong discriminator for obstructive CAD and can with high sensitivity and specificity and correlates
well with the degree of obstruction even more than Framingham risk estimate which has high sensitivity and low
specificity.
Conclusion:
CCS helps reducing the effective radiation dose if properly evaluated to skip unnecessary CTCA if
obstructive lesions was unlikely, and as a test does not use contrast material, harmful effect on the kidney will be avoided
as most of coronary atherosclerotic patients have renal problems.
Usefulness of Additional Coronary Calcium Scoring in Low-dose CT Coronary Angiography with Prospective ECG-Triggering