Comparison of calcium scoring with 4-multidetector computed tomography (4-MDCT) and 64-MDCT: a phantom study.

Objective: To determine differences in coronary artery calcium (CAC) measurement performed with the use of 2 generations of multidetector computed tomography (CT) scanners of the same manufacturer.

Methods: Agatston Score (AS) and calcium mass (CM) were measured with a 4-row scanner (AS4 and CM4) and a 64-row scanner (AS64 and CM64) using a cardiac phantom with calcium inserts.

Results: The results of the AS measurements (mean ± SD) varied significantly between the equipment: 880.6 ± 30.1 (AS4) vs 586.5 ± 24.0 (AS64; P < 0.0001). The AS interscanner variability was 31.6% for the phantom and from 25.5% to 110.1% for particular inserts. Mean ± SD CM values were different as well: 192.8 ± 5.0 mg (CM4) vs 152.4 ± 2.6 mg (CM64; P < 0.0001). Determination of CM with 64-row CT was more accurate than that with an older scanner; the mean relative error was -9.1% and 15.0%, respectively (P < 0.0001). The CM interscanner variability was 23.3% for the phantom and from 19.0% to 122.8% for particular inserts. The interexamination variability ranged from 1.7% (CM64) to 5.6% (AS4).

Conclusions: Coronary artery calcium scoring with the 64-row CT scanner is more accurate than with the 4-row device The difference between the results of AS and CM measurements carried out with both scanners is statistically significant.