High-pitch Low-dose Chest Computed Tomography With Calcium-aware Reconstruction for Coronary Artery Calcium…

StudyJournal of thoracic imaging· Aug 2026

High-pitch Low-dose Chest Computed Tomography With Calcium-aware Reconstruction for Coronary Artery Calcium Scoring: Accuracy and Dose Reduction.

He Zhang, Lulu Zhang, Zhen Wang … Kai Xu

RadiologyStudyDiagnosisQ2IF 1.4

High-pitch low-dose CT protocol cut radiation dose 62% versus standard calcium scoring scan

High-pitch Low-dose Chest Computed Tomography With Calcium-aware Reconstruction for Coronary Artery Calcium Scoring: Accuracy and Dose Reduction.

He Zhang … Kai Xu

Journal of thoracic imaging · Aug 2026 · Q2 in Radiology

Purpose

To evaluate the accuracy, radiation dose, and clinical feasibility of a high-pitch low-dose chest CT (Sa36LDCT) scanning protocol with calcium-aware reconstruction for coronary artery calcium scoring (CAC).

Methods

In this prospective study, 90 patients underwent both standard CAC scanning (Qr36CACS, 120 kVp) and Sa36LDCT (70 to 120 kVp, high-pitch, ATVS).

n = 90 patients

Results

high-pitch protocol nearly halves radiation exposure, image quality unaffected

0.74mSv

Qr36CACS

0.28mSv

Sa36LDCT

More results

CAC metrics showed no significant difference between protocols, with excellent agreement (ICC = 0.983 to 0.996).

Subgroup analysis revealed that heart rate did not significantly influence CAC quantification or risk classification, with Agatston score ICC values of 0.98 for ≤75 bpm and 0.99 for >75 bpm, demonstrating similar accuracy in both subgroups.

More results

Risk stratification based on Agatston categories showed near-perfect consistency across heart rate subgroups (weighted k = 0.957).

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Conclusion · 1 of 2

High-pitch Sa36LDCT provides accurate and reliable CAC scoring equivalent to standard CAC scoring, with substantial radiation dose reduction and preserved image quality.

Conclusion · 2 of 2

The protocol's robustness across heart rate subgroups demonstrates its potential as a safe and practical approach for combined pulmonary and cardiovascular screening, pending validation in larger, more diverse populations.

High-pitch Low-dose Chest Computed Tomography With Calcium-aware Reconstruction for Coronary Artery Calcium Scoring: Accuracy and Dose Reduction.

High-pitch Low-dose Chest Computed Tomography With Calcium-aware Reconstruction for Coronary Artery Calcium Scoring: Accuracy and Dose Reduction.

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