TY - JOUR
T1 - Radiography and Computed Tomography Detection of Intimal and Medial Calcifications in Leg Arteries in Comparison to Histology
AU - Vos, Annelotte
AU - Vink, Aryan
AU - Kockelkoren, Remko
AU - Takx, Richard A. P.
AU - Celeng, Csilla
AU - Mali, Willem P. T. M.
AU - Isgum, Ivana
AU - Bleys, Ronald L. A. W.
AU - de Jong, Pim A.
N1 - Funding Information: This research is supported by a grant of the Netherlands Organization for Scientific Research/Foundation for Technological Sciences (NWO/STW, Project 12726) with industrial contribution (Pie Medical Imaging BV and 3mensio Medical Imaging BV). Csilla Celeng is supported by a grant from the European Association of Cardiovascular Imaging (EACVI). The funding agencies had no role in the design and conduct of the study, data collection, analysis, and interpretation, or preparation, review, or approval of the manuscript. Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2022/5/1
Y1 - 2022/5/1
N2 - Calcifications are common in the tunica intima and tunica media of leg arteries. There is growing interest in medial arterial calcifications, as they may be modifiable with treatment. We aimed to investigate radiography and computed tomography (CT) for the detection and characterization of both types of arterial calcification in leg arteries in relation to histology. In a postmortem study we therefore investigated 24 popliteal and 24 tibial arteries. The reference standard was presence of arterial calcification and the dominance of intimal or medial calcification on histology. Radiographs and CT scans were scored for presence of calcification and for dominant intimal or medial pattern based on prespecified criteria (annularity, thickness, continuity). Both radiography and CT detected 87% of histologically proven calcifications but missed mild calcifications in 13%. When only the arteries with detected calcifications were included, a moderate agreement was observed on intimal/medial location of calcifications between histology and radiography (correct in 19/24 arteries (79%); Kappa 0.58) or CT (correct in 33/46 arterial segments (72%); Kappa 0.48). With both modalities there was a slight tendency to classify intimal calcifications as being located in the media and to miss media calcification. Our study demonstrates the potential and limitations of both radiography and CT to detect and classify arterial calcifications in leg arteries.
AB - Calcifications are common in the tunica intima and tunica media of leg arteries. There is growing interest in medial arterial calcifications, as they may be modifiable with treatment. We aimed to investigate radiography and computed tomography (CT) for the detection and characterization of both types of arterial calcification in leg arteries in relation to histology. In a postmortem study we therefore investigated 24 popliteal and 24 tibial arteries. The reference standard was presence of arterial calcification and the dominance of intimal or medial calcification on histology. Radiographs and CT scans were scored for presence of calcification and for dominant intimal or medial pattern based on prespecified criteria (annularity, thickness, continuity). Both radiography and CT detected 87% of histologically proven calcifications but missed mild calcifications in 13%. When only the arteries with detected calcifications were included, a moderate agreement was observed on intimal/medial location of calcifications between histology and radiography (correct in 19/24 arteries (79%); Kappa 0.58) or CT (correct in 33/46 arterial segments (72%); Kappa 0.48). With both modalities there was a slight tendency to classify intimal calcifications as being located in the media and to miss media calcification. Our study demonstrates the potential and limitations of both radiography and CT to detect and classify arterial calcifications in leg arteries.
KW - atherosclerosis
KW - computed tomography
KW - histology
KW - medial arterial calcification
KW - radiography
KW - vascular calcification
UR - http://www.scopus.com/inward/record.url?scp=85129901765&partnerID=8YFLogxK
U2 - https://doi.org/10.3390/jpm12050711
DO - https://doi.org/10.3390/jpm12050711
M3 - Article
C2 - 35629134
SN - 2075-4426
VL - 12
JO - Journal of personalized medicine
JF - Journal of personalized medicine
IS - 5
M1 - 711
ER -