A correction score to compare aortic calcification in contrast enhanced and non-contrast measurements from computed tomography scans

Steven R Horbal; Edward Brown; Brian A Derstine; Peng Zhang; Aurelian Bidulescu; June A Sullivan; Brian E Ross; Grace L Su; Sven A Holcombe; Stewart C Wang

doi:10.1016/j.clinimag.2021.11.022

A correction score to compare aortic calcification in contrast enhanced and non-contrast measurements from computed tomography scans

Clin Imaging. 2022 Mar:83:51-55. doi: 10.1016/j.clinimag.2021.11.022. Epub 2021 Dec 1.

Authors

Affiliations

¹ Morphomic Analysis Group, University of Michigan, Ann Arbor, MI, USA. Electronic address: shorbal@med.umich.edu.
² Morphomic Analysis Group, University of Michigan, Ann Arbor, MI, USA. Electronic address: edbr@med.umich.edu.
³ Morphomic Analysis Group, University of Michigan, Ann Arbor, MI, USA. Electronic address: bderstin@med.umich.edu.
⁴ Morphomic Analysis Group, University of Michigan, Ann Arbor, MI, USA. Electronic address: pczhang@med.umich.edu.
⁵ Indiana University School of Public Health, Bloomington, IN, USA. Electronic address: abidules@med.umich.edu.
⁶ Morphomic Analysis Group, University of Michigan, Ann Arbor, MI, USA. Electronic address: jusulli@med.umich.edu.
⁷ Morphomic Analysis Group, University of Michigan, Ann Arbor, MI, USA. Electronic address: rosbrian@med.umich.edu.
⁸ VA Ann Arbor Healthcare System, Ann Arbor, MI, USA. Electronic address: gsu@med.umich.edu.
⁹ Morphomic Analysis Group, University of Michigan, Ann Arbor, MI, USA. Electronic address: svenho@med.umich.edu.
¹⁰ Department of Surgery, University of Michigan, Ann Arbor, MI, USA. Electronic address: stewartw@med.umich.edu.

PMID: 34954502
DOI: 10.1016/j.clinimag.2021.11.022

Abstract

Background: Aortic wall calcification shows strong promise as a cardiovascular risk factor. While useful for visual enhancement of vascular tissue, enhancement creates heterogeneity between scans with and without contrast. We evaluated the relationship between aortic calcification in routine abdominal computed tomography scans (CT) with and without contrast.

Methods: Inclusion was limited to those with abdominal CT-scans with and without contrast enhancement within 120 days. Analytic Morphomics, a semi-automated computational image processing system, was used to provide standardized, granular, anatomically indexed measurements of aortic wall calcification from abdominal CT-scans. Aortic calcification area (ACA) and aortic wall calcification percent (ACP) and were the outcomes of interest. Multiple linear regression was used to evaluate the relationship of aortic measurements. Models were further controlled for age and sex. Stratification of measurements by vertebral level was also performed.

Results: A positive association was observed for non-contrast calcification in ACP β 0.74 (95% CI 0.72, 0.76) and ACA β 0.44 (95% 0.43, 0.45). Stratified results demonstrated the highest coefficient of determination at L2 for percent and L3 for area models [R² 0.91 (ACP) 0.74 (ACA)]. Adjusted lumber-level associations between non-contrast and contrast measurements ranged from (β 0.69-0.82) in ACP and (β 0.37-0.54) in ACA.

Conclusion: A straightforward correction score for comparison of abdominal aortic calcification measurements in contrast-enhanced and non-contrast scans is discussed. Correction of aortic calcification from CT scans can reduce scan heterogeneity and will be instrumental in creating larger cardiovascular cohorts as well as cardiovascular risk surveillance programs.

Keywords: Aortic calcification; Cardiovascular risk; Computed tomography scans; Morphomics; Standardization.

MeSH terms

Humans
Image Processing, Computer-Assisted
Radionuclide Imaging
Tomography, X-Ray Computed / methods
Vascular Calcification* / diagnostic imaging