Automatic Calcium Score Assessment from Coronary CTA Shows Potential to Eliminate Need for Separate Scan

Proof-of-concept has been achieved with the first fully automated software that performs calcium scoring directly from a coronary computed tomography angiography (cCTA) study. This technology, the first to show strong correlation with the standard Agatston scoring, has the potential to eliminate the need for a separate calcium score (CS) exam, and thereby reduce costs and decrease patient radiation exposure.

This work in progress is based on Rcadia Medical Imaging (Newton, MA, USA) COR analyzer system technology for fully automatic detection of stenosis in cCTA studies.

CS is an important predictor of coronary artery disease that is typically used by cardiologists. Until recently, a separate calcium scoring CT study was frequently conducted prior to a cCTA exam. With the new generation of CT scanners, CS can be accomplished from cCTA; a separate CS study, which increases the patient’s radiation exposure, has the potential to be avoided. The feasibility of this approach has been demonstrated by a number of studies using semi-automatic segmentation of calcified lesions. Rcadia is developing a system based on a fully automatic approach designed to bring simplicity and consistency into this technique.

To evaluate the diagnostic performance of the system, a retrospective trial was conducted based on cCTA and standard calcium scoring studies of 215 patients. Calcium score automatically computed from cCTA by Rcadia’s software was compared to the Agatston score obtained from nonenhanced calcium scoring studies using the standard technique. The system demonstrated good correlation with the standard Agatston score, achieving 90% accuracy for the classification into five calcium score ranges (0, 1-10, 11-100, 101-400, and above 400). The company believes the trial is the first reported study to match an automatically computed calcium score from cCTA to the standard Agatston score from non-enhanced calcium scoring studies.

“The promising results of this first trial suggest that automatic calcium score assessment has potential to increase the value of the cCTA exam,” said Shai Levanon, president and CEO of Rcadia. “The software will be optimized and validated in future studies.” He noted, “The calcium scoring application is in line with the company’s vision of providing a comprehensive analysis of coronary arteries, including quantitative assessment of the total coronary plaque burden and introduction of an alternative to calcium score with better predictive value.”

Rcadia Medical Imaging, Ltd. develops and markets proprietary computerized systems that automatically detect clinical abnormalities in digital medical images, particularly for patient triage in emergency, life-threatening conditions. The company’s first US Food and Drug Administration (FDA)-cleared product, the COR analyzer system, provides fully automated, real-time analysis of coronary CT angiography to enable the practical application of cCTA in detecting significant coronary artery disease. The COR analyzer improves the utility of coronary CTA studies in the emergency department to triage chest pain patients and optimizes workflow in cardiology and radiology departments.

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