Skip to main content
SpringerLink
Log in

Role of Noninvasive Imaging using CT for Detection and Quantitation of Coronary Atherosclerosis

  • Chapter
  • First Online:
Asymptomatic Atherosclerosis

Part of the book series: Contemporary Cardiology ((CONCARD))

  • 1260 Accesses

Abstract

Cardiac CT began with electron beam CT in the early 1980s and continues now with multidetector CT in the twenty-first century. The major applications of noncontrast cardiac CT are currently for the quantification of coronary artery calcium – a reliable and repeatable means to estimate atherosclerotic plaque burden. The major applications of contrast-enhanced CT (CT angiography) is for more detailed estimation of total plaque burden by qualitatively defining “noncalcified” and complex plaque as well as ruling out obstructive coronary artery disease. Both of these applications are discussed, along with historical perspectives, in this review.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 229.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 299.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 299.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Hounsfield GN. Computerized transverse axial scanning (tomography). Par 1. Description of system. Br J Radiol 1973;46:1016–22

    Article  PubMed  CAS  Google Scholar 

  2. Ambrose J. Computerized transverse axial scanning (tomography). Part II. Clinical applications. Br J Radiol 1973;46:1023–27

    Article  PubMed  CAS  Google Scholar 

  3. Boyd D. A proposed dynamic cardiac 3-D densitometer for early detection and evaluation of heart disease. IEEE Trans Nuc/Sci 1979;N26:2724

    Google Scholar 

  4. Boyd DP, Couch JL, Napel SA, Peschmann KR, Rand RE. Ultrafast cine CT: where have we been? What lies ahead? Am J Cardiac Imaging 1987;1:175–85

    Google Scholar 

  5. Rumberger JA, Lipton MJ. Ultrafast cardiac CT scanning. Cardiol Clin 1989;7:713–34

    PubMed  CAS  Google Scholar 

  6. Rumberger JA, Sheedy PF, Breen JF (1996) Use of ultrafast (cine) X-ray computed tomography in cardiac and cardiovascular imaging. In: Giuliani ER, Gersh BJ, McGoon MD, Hayes DL, Schaff HF (eds), Mayo clinic practice of cardiology, 3rd edn. Mosby, St. Louis, Chapter 8, pp 303–324.

  7. Rumberger JA, Feiring AJ, Lipton MJ, Higgins CB, Marcus ML. Measurement of myocardial perfusion by ultrafast CT. J Am Coll Cardiol 1985;5(2):500

    Google Scholar 

  8. Rumberger JA, Gersh BJ. Non-parallel changes in global chamber volume and muscle mass during the first year following transmural myocardial infarction in man: letter to the editor. J Am Coll Cardiol 1993;22:2060-1

    Article  Google Scholar 

  9. Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M, Detrano R. Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 1990;15:827–32

    Article  PubMed  CAS  Google Scholar 

  10. Moshage WE, Achenbach S, Seese B, Bachmann K, Kirchgeorg M. Coronary artery stenoses: three-dimensional imaging with electrocardiographically triggered, contrast-enhanced, electron beam CT. Radiology 1995;196:707–14

    PubMed  CAS  Google Scholar 

  11. Schmermund A, Rensing BJ, Sheedy PF, Bell MR, Rumberger JA. Intravenous electron-beam CT coronary angiography for segmental analysis of coronary artery stenoses. J Am Coll Cardiol 1998;31:1547–54

    Article  PubMed  CAS  Google Scholar 

  12. Rifkin RD, Parisi AF, Folland E. Coronary calcification in the diagnosis of coronary artery disease. Am J Cardiol 1979;44:141–7

    Article  PubMed  CAS  Google Scholar 

  13. McCarthy JH, Palmer FJ. Incidence and significance of coronary artery calcification. Br Heart J 1974;36:499–506

    Article  PubMed  CAS  Google Scholar 

  14. Rumberger JA, Simons DB, Fitzpatrick LA, et al. Coronary artery calcium areas by electron beam computed tomography and coronary atherosclerotic plaque area: a histopathologic correlative study. Circulation 1995;92:2157–62

    Article  PubMed  CAS  Google Scholar 

  15. Baumgart D, Schmermund A, Goerge G, et al. Comparison of electron beam computed tomography with intracoronary ultrasound and coronary angiography for detection of coronary atherosclerosis. J Am Coll Cardiol 1997;30:57–64

    Article  PubMed  CAS  Google Scholar 

  16. Schmermund A, Baumgart D, Gorge G, et al. Coronary artery calcium in acute coronary syndromes: a comparative study of electron beam CT, coronary angiography, and intracoronary ultrasound in survivors of acute myocardial infarction and unstable angina. Circulation 1997;96:1461–9

    Article  PubMed  CAS  Google Scholar 

  17. Rumberger JA, Brundage BH, Rader DJ, Kondos G. Electron beam CT coronary calcium scanning: a review and guidelines for use in asymptomatic individuals. Mayo Clin Proc 1999;74:243–52

    Article  PubMed  CAS  Google Scholar 

  18. Callister TQ, Cooil B, Raya SP, et al. Coronary artery disease: improved reproducibility of calcium scoring with an electron-beam CT volumetric method. Radiology 1998;208:807–14

    PubMed  CAS  Google Scholar 

  19. Hoff JA, Chomka EV, Krainik AJ, et al. Age and gender distributions of coronary artery calcium detected by electron beam tomography in 35,246 Adults. Am J Cardiol 2001;87:1335–9

    Article  PubMed  CAS  Google Scholar 

  20. Schmermund A, Erbel R, Silber S. Age and gender distribution of coronary artery calcium measured by four-slice computed tomography in 2,030 persons with no symptoms of coronary artery disease. Am J Cardiol 2002;90:169–73

    Article  Google Scholar 

  21. Budoff MJ, Yang TP, Shavelle RM. Ethnic differences in coronary atherosclerosis. J Am Coll Cardiol 2002;39:408–12

    Article  PubMed  Google Scholar 

  22. Newman AB, Naydeck BL, Whittle J, et al. Racial differences in coronary artery calcification in adults. Arterioscler Thromb Vasc Biol 2002;22:424–30

    Article  PubMed  CAS  Google Scholar 

  23. Khuran C, Rosenbaum CG, Howard BV, et al. Coronary artery calcification in black women and white women. Am Heart J 2003;145:724–9

    Article  Google Scholar 

  24. Jain T, Peshock R, Darren K. McGuire DK, et al. African Americans and Caucasians have a similar prevalence of coronary calcium in the Dallas Heart Study. J Am Coll Cardiol 2004;44:1011–7

    Article  PubMed  CAS  Google Scholar 

  25. Budoff MJ, Shaw LJ, Liu ST, Weinstein SR, Mosler TP, Tseng PH, Flores FR, Callister TR, Raggi P, Berman DS. Long term prognosis associated with coronary calcium: observations from a registry of 25,253 patients. JACC 2007;49:1860–70

    Article  PubMed  Google Scholar 

  26. Nasir K, Shaw LJ, Liu ST, Weinstein SR, Mosler TR, Flores PR, Flores FR, Raggi P, Berman DS, Blumenthal RS, Budoff MJ. Ethnic differences in the prognostic value of coronary artery calcification for all-cause mortality. JACC 2007;50:953–60

    Article  PubMed  Google Scholar 

  27. Third report of the National Cholesterol Education Program (NCEP) Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) Final Report. NIH Publication No. 02-5215. September 2002.

    Google Scholar 

  28. Kondos GT, Hoff JA, Sevrukov A, et al. Coronary artery calcium and cardiac events electron-beam tomography coronary artery calcium and cardiac events: a 37-month follow-up of 5,635 initially asymptomatic low to intermediate risk adults. Circulation 2003;107:2571–6

    Article  PubMed  Google Scholar 

  29. Shaw LJ, Raggi P, Schisterman E, et al. Prognostic value of cardiac risk factors and coronary artery calcium screening for all-cause mortality. Radiology 2003;28:826–33

    Article  Google Scholar 

  30. Greenland P, LaBree L, Azen SP, et al. Coronary artery calcium score combined with Framingham score for risk prediction in asymptomatic individuals. JAMA 2004;291:210–5

    Article  PubMed  CAS  Google Scholar 

  31. Arad Y, Goodman KJ, Roth M, et al. Coronary calcification, coronary risk factors, C-reactive protein and atherosclerotic cardiovascular disease events: the St. Francis Heart Study. J Am Coll Cardiol 2005;46:158–65

    Article  PubMed  CAS  Google Scholar 

  32. Tuzcu EM, Kapadia SR, Tutar E, et al. High prevalence of coronary atherosclerosis in asymptomatic teenagers and young adults: evidence from intravascular ultrasound. Circulation 2001;103:2705–10

    Article  PubMed  CAS  Google Scholar 

  33. Raggi P, Callister TQ, Cooil B, et al. Identification of patients at increased risk of first unheralded acute myocardial infarction by electron beam computed tomography. Circulation 2000;101:850–5

    Article  PubMed  CAS  Google Scholar 

  34. Budoff MJ, Ehrlich J, Hecht HS, Rumberger JR. Letter to the editor. JAMA 2004;291:1822

    Article  Google Scholar 

  35. Achenbach S, Moselewski F, Ropers D, Ferencik M, Hoffman U, MacNeill B, Phole K, Baum U, Anders K, Jang IK, Daniel WG, Brady TJ. Detection of calcified and noncalcified coronary atherosclerotic plaque by contrast-enhanced submillimeter multidetector spiral computed tomography. Circulation 2004;109:14–7

    Article  PubMed  Google Scholar 

  36. Leber AW, Knez A, Becker A, Becker C, Ziegler F, Nikolaou K, Rist C, Reiser M, White C, Steinbeck G, Boekstegers P. Accuracy of multidetector spiral computed tomography in identifying and differentiating the composition of coronary atherosclerotic plaques. JACC 2004;43:1241–7

    Article  PubMed  Google Scholar 

  37. Leber AW, Becker A, Knez A, et al. Accuracy of 64-slice CT to classify and quantify plaque volume in the proximal coronary system: a comparison study with intravascular ultrasound. J Am Coll Cardiol 2006;47:672–7

    Article  PubMed  Google Scholar 

  38. Greenland P, Smith SC, Grundy SM. Improving coronary heart disease risk assessment in asymptomatic people: role of traditional risk factors and noninvasive cardiovascular tests. Circulation 2001;104:1863-7

    Article  PubMed  CAS  Google Scholar 

  39. O’Rourke RA, Brundage BH, Froelicher VF, et al. American College of Cardiology/American Heart Association expert consensus document on electron beam computed tomography for the diagnosis and prognosis of coronary artery disease. Circulation 2000;102:126–34

    Article  PubMed  Google Scholar 

  40. Mieres JH, Shaw LJ; Andrew Arai A, et al. AHA scientific statement: role of noninvasive testing in the clinical evaluation of women with suspected coronary artery disease. Consensus statement from the Cardiac Imaging Committee, Council on Clinical Cardiology, and the Cardiovascular Imaging and Intervention Committee, Council on Cardiovascular Radiology and Intervention, American Heart Association. Circulation 2005;111:682–96

    Article  PubMed  Google Scholar 

  41. Wilson PWF, D’Agostino B, Levy D, et al. Prediction of coronary heart disease using risk factor categories. Circulation 1998;97:1837–47

    Article  PubMed  CAS  Google Scholar 

  42. Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) (Adult Treatment Panel III). JAMA 2001;285:2486–97

    Article  Google Scholar 

  43. Pohle K, Ropers D, Mäffert R, et al. Coronary calcifications in young patients with first, unheralded myocardial infarction: a risk factor matched analysis by electron beam tomography. Heart 2003;89:625–8

    Article  PubMed  CAS  Google Scholar 

  44. Smith SC, Greenland P, Grundy SM. Prevention conference V: beyond secondary prevention: identifying the high-risk patient for primary prevention. Executive summary. Circulation 2000;101:111–6

    Article  PubMed  Google Scholar 

  45. Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20 536 high-risk individuals: a randomized placebo-controlled trial. Lancet 2002;360:7–22

    Article  Google Scholar 

  46. Raggi P, Cooil B, Callister TQ. Use of electron beam tomography data to develop models for prediction of hard coronary events. Am Heart J 2001;141:375–82

    Article  PubMed  CAS  Google Scholar 

  47. Grundy SM, Cleeman JI, Merz CN, et al. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines. Circulation 2004;110:227–39

    Article  PubMed  Google Scholar 

  48. Raggi P, Shaw LJ, Berman DS, Callister TQ. Prognostic value of coronary artery calcium screening in subjects with and without diabetes. J Am Coll Cardiol 2004;43:1663–9

    Article  PubMed  CAS  Google Scholar 

  49. Callister TQ, Raggi P, Cooil B, et al. Effect of HMG-CoA reductase inhibitors on coronary artery disease as assessed by electron beam computed tomography. N Engl J Med 1998;339:1972–8

    Article  PubMed  CAS  Google Scholar 

  50. Budoff MJ, Lane KL, Bakhsheshi H, et al. Rates of progression of coronary calcium by electron beam tomography. Am J Cardiol 2000;86:8–11

    Article  PubMed  CAS  Google Scholar 

  51. Achenbach S, Ropers D, Pohle K, et al. Influence of lipid-lowering therapy on the progression of coronary artery calcification: a prospective evaluation. Circulation 2002;106:1077–82

    Article  PubMed  CAS  Google Scholar 

  52. Shavelle DM, Takasu J, Budoff MJ, et al. HMG CoA reductase inhibitor (statin) and aortic valve calcium. Lancet 2002;359(9312):1125–6

    Article  PubMed  CAS  Google Scholar 

  53. Raggi P, Cooil B, Shaw L, et al. Progression of coronary calcification on serial electron beam tomography scanning is greater in patients with future myocardial infarction. Am J Cardiol 2003;92:827–9

    Article  PubMed  Google Scholar 

  54. Raggi P, Callister TQ, Shaw LJ. Progression of coronary artery calcium and risk of first myocardial infarction in patients receiving cholesterol-lowering therapy. Arterioscler Thromb Vasc Biol 2004;24:1–7

    Article  Google Scholar 

  55. Hecht HS Harman SM. Changes in calcified plaque and serum lipoprotein values: evaluation by electron beam tomography in treated and untreated asymptomatic patients. Am J Cardiol 2003;91:1131–4

    Article  PubMed  Google Scholar 

  56. Nakinishi T, Ito K, Imazu M, Yamakido, M. Evaluation of coronary artery stenoses using electron-beam CT and mutiplanar reformation. J Comp Assist 1997;21:121–7

    Article  Google Scholar 

  57. Reddy GP, Chernoff DM, Adams JR, Higgins CB. Coronary artery stenoses: 59 assessment with contrast-enhanced electron-beam CT and axial reconstructions. Radiology 1998;208:167–72

    PubMed  CAS  Google Scholar 

  58. Rensing BJ, Bongaerts A, van Geuns RJ, van Ooijen P, Oudkerk M de Feyter PJ. Intravenous coronary angiography by electron beam computed tomography: a clinical evaluation. Circulation 1998;98:2509–12

    Article  PubMed  CAS  Google Scholar 

  59. Achenbach S, Moshage W. Ropers D, Nossen J, Daniel WG. Value of electron beam computed tomography for the noninvasive detection of high-grade coronary artery stenoses and occlusions. N Engl J Med 1998;339:1964–71

    Article  PubMed  CAS  Google Scholar 

  60. Budoff MJ, Oudiz RJ, Zalace CP, Bakhsdeshi H, Goldberg SL, French WJ, Rami TG, Brundage BH. Intravenous three-dimensional coronary angiography using contrast enhanced electron beam computed tomography. Am J Cardiol 1999;83:840–5

    Article  PubMed  CAS  Google Scholar 

  61. Achenbach S, Ropers D, Regenfus M, Uizheimer S, Derlien H, Schulte C, Wenkel E, Moshage W, Bautz W, Daniel WG. Contrast enhanced electron beam computed tomography to analyze the coronary arteries in patients after acute myocardial infarction. Heart 2000;84:489–93

    Article  PubMed  CAS  Google Scholar 

  62. Leber AW, Knez A, Mukherjee R, White C, Huber A, Becker A, Becker CR, Reiser M, Haberl R, Steinbeck G. Usefulness of calcium scoring using electron beam computed tomography and noninvasive coronary angiography in patients with suspected coronary artery disease. Am J Cardiol 2001;88:219–23

    Article  PubMed  CAS  Google Scholar 

  63. Ropers D, Regenfus M, Stilanakis N, Birke S, Kessler W, Moshage W, Laub G, Daniel WG, Achenbach S. A direct comparison of noninvasive coronary angiography by electron beam tomography and navigator-echobased magnetic resonance imaging for detection of restenosis following coronary angioplasty. Invest Radiol 2002;37:386–92

    Article  PubMed  Google Scholar 

  64. Nikolaou K, Huber A, Knez A, Breuning R, Reiser M. Intraindividual comparison of contrast-enhanced electron-beam computed tomography and navigator echo-based magnetic resonance imaging for noninvasive coronary artery angiography. Eur Radiol 2002;12:1663–71

    Article  PubMed  Google Scholar 

  65. Rasouli ML, Budoff M, Mao S, et al. Detection of coronary stenosis using e-Speed electron beam tomography. Circulation 2003;108:IV–527 (abstract)

    Google Scholar 

  66. Nieman K, Cademartiri F, Lemos P, Raaijmakers R, Pattynama P, de Feyter P. Reliable non-invasive coronary angiography sung sub-millimetre multislice spiral CT. Circulation 2002;106:2051–4

    Article  PubMed  Google Scholar 

  67. Ropers D, Baum U, Pohle K, Katharina MD, Anders K, Ulzheimer S, Ohnesorge B, Schlundt C, Bautz W, Daniel WG, Achenbach S. Detection of coronary artery stenoses with thin-slice multi-detector row spiral computed tomography and multiplanar reconstruction. Circulation 2003;107:664–6

    Article  PubMed  Google Scholar 

  68. Mollet NR, Cademartiri F, Nieman K, Saia F, Lemos PA, McFadden EP, Pattynama PMT, Serruys PW, Krestin GP, de Feyter P. MSCT coronary angiography in stable angina. J Am Coll Cardiol 2004;43:2265–70

    Article  PubMed  Google Scholar 

  69. Achenbach S, Giesler A, Moshage W, Ropers D, Nossen J, Bachmann K. Noninvasive three-dimensional visualization of coronary artery bypass grafts by electron beam tomography. Am J Cardiol 1997;88:792–5

    Google Scholar 

  70. Ropers D, Ulzheimer S, Wenkel E, Anders K, Ohnesorge B, Schlundt C, Bautz W, Daniel WG, Achenbach S. Investigation of aortocoronary artery bypass grafts by multislice spiral computed tomography with electrocardiographic-gated image reconstruction. Am J Cardiol 2001;88:792–5

    Article  PubMed  CAS  Google Scholar 

  71. Schlosser T, Konorza T, Hunold P, Huhl H. Schmermund A, Barkhausen J. Noninvasive visualization of coronary artery bypass grafts using 16-detector row computed tomography. J Am Coll Cardiol 2004;44:1224–9

    Article  PubMed  Google Scholar 

  72. Martuscelli E, Romagnoli A, D’Eliseo A, Tomassini M, Razzini C, Sperandio CM, Simonetti G, Romeo F, Mehta JL. Evaluation of venous and arterial conduit patency by 16-slice spiral computed tomography. Circulation 2004;110:3234–28

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The Princeton Longevity Center, Princeton, NJ, USA

    John A. Rumberger

Authors
  1. John A. Rumberger
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Endothelix, Inc., El Rio 8275, Houston, 77054, USA

    Morteza Naghavi

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Rumberger, J.A. (2011). Role of Noninvasive Imaging using CT for Detection and Quantitation of Coronary Atherosclerosis. In: Naghavi, M. (eds) Asymptomatic Atherosclerosis. Contemporary Cardiology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-179-0_24

Download citation

  • DOI: https://doi.org/10.1007/978-1-60327-179-0_24

  • Published:

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-60327-178-3

  • Online ISBN: 978-1-60327-179-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation