Assessment of aortic and iliac artery calcification using CT-angiography in kidney transplant candidates

Abstract Purpose Assessment of vascular calcification provides the opportunity for risk stratification in kidney transplant candidates (KTCs), as vascular calcification constitutes an independent risk factor for cardiovascular events. The aim of the present study is to explore the feasibility of con...

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Main Authors: Ola Sobhy A. Elmeseiny, Simon Winther, Hanne Skou Jørgensen, My Svensson, Morten Bøttcher, Per Ivarsen, Gratien Andersen, Henrik Birn, Marie Bodilsen Nielsen
Format: Article
Language:English
Published: SpringerOpen 2025-05-01
Series:CVIR Endovascular
Online Access:https://doi.org/10.1186/s42155-025-00542-1
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author Ola Sobhy A. Elmeseiny
Simon Winther
Hanne Skou Jørgensen
My Svensson
Morten Bøttcher
Per Ivarsen
Gratien Andersen
Henrik Birn
Marie Bodilsen Nielsen
author_facet Ola Sobhy A. Elmeseiny
Simon Winther
Hanne Skou Jørgensen
My Svensson
Morten Bøttcher
Per Ivarsen
Gratien Andersen
Henrik Birn
Marie Bodilsen Nielsen
author_sort Ola Sobhy A. Elmeseiny
collection DOAJ
description Abstract Purpose Assessment of vascular calcification provides the opportunity for risk stratification in kidney transplant candidates (KTCs), as vascular calcification constitutes an independent risk factor for cardiovascular events. The aim of the present study is to explore the feasibility of contrast enhanced computed tomography (CT)-angiography to quantitate vascular calcification, to avoid the extra radiation of an additional non-contrast CT scan. Methods and materials 43 KTCs who underwent concomitant non-contrast CT scans and CT-angiographies of the infrarenal aorta and iliac arteries were included. Vascular calcification was quantified using the Agatston method on non-contrast CT and applying individual Hounsfield Unit thresholds on CT-angiographies based on the radio density of the aortic lumen. The calcium scores and volumes from non-contrast CT scans and CT-angiographies were compared using linear regression and Bland–Altman plots. Results Non-contrast CT revealed vascular calcification in the infrarenal aorta in 92% of KTCs and in the iliac arteries in 90% of KTCs. The calcium scores estimated from CT-angiography correlated linearly with the calcium scores based on non-contrast CT scans (infrarenal aorta: R2 = 0.71, p < 0.0001; iliac arteries: R2 = 0.71, p < 0.0001); however, the calcium scores were higher, and volumes were lower compared to the non-contrast CT scans. The median differences in calcium scores were 1517 [48 – 6138] for the infrarenal aorta, and 2361 [59 – 8644] for the iliac arteries. Conclusion Vascular calcification is present in the majority of KTCs. Calcification of the infrarenal aorta and iliac arteries may be assessed using CT-angiography, though higher calcium scores and lower volumes are found compared to the non-contrast CT scan.
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spelling doaj-art-7bdcfc30df35444eab83d8292f1de40d2025-08-20T01:49:36ZengSpringerOpenCVIR Endovascular2520-89342025-05-01811810.1186/s42155-025-00542-1Assessment of aortic and iliac artery calcification using CT-angiography in kidney transplant candidatesOla Sobhy A. Elmeseiny0Simon Winther1Hanne Skou Jørgensen2My Svensson3Morten Bøttcher4Per Ivarsen5Gratien Andersen6Henrik Birn7Marie Bodilsen Nielsen8Department of Biomedicine, Aarhus UniversityDepartment of Cardiology, Gødstrup HospitalDepartment of Renal Medicine, Aarhus University HospitalDepartment of Nephrology, Aalborg University HospitalDepartment of Cardiology, Gødstrup HospitalDepartment of Biomedicine, Aarhus UniversityDepartment of Radiology, Aarhus University HospitalDepartment of Biomedicine, Aarhus UniversityDepartment of Renal Medicine, Aarhus University HospitalAbstract Purpose Assessment of vascular calcification provides the opportunity for risk stratification in kidney transplant candidates (KTCs), as vascular calcification constitutes an independent risk factor for cardiovascular events. The aim of the present study is to explore the feasibility of contrast enhanced computed tomography (CT)-angiography to quantitate vascular calcification, to avoid the extra radiation of an additional non-contrast CT scan. Methods and materials 43 KTCs who underwent concomitant non-contrast CT scans and CT-angiographies of the infrarenal aorta and iliac arteries were included. Vascular calcification was quantified using the Agatston method on non-contrast CT and applying individual Hounsfield Unit thresholds on CT-angiographies based on the radio density of the aortic lumen. The calcium scores and volumes from non-contrast CT scans and CT-angiographies were compared using linear regression and Bland–Altman plots. Results Non-contrast CT revealed vascular calcification in the infrarenal aorta in 92% of KTCs and in the iliac arteries in 90% of KTCs. The calcium scores estimated from CT-angiography correlated linearly with the calcium scores based on non-contrast CT scans (infrarenal aorta: R2 = 0.71, p < 0.0001; iliac arteries: R2 = 0.71, p < 0.0001); however, the calcium scores were higher, and volumes were lower compared to the non-contrast CT scans. The median differences in calcium scores were 1517 [48 – 6138] for the infrarenal aorta, and 2361 [59 – 8644] for the iliac arteries. Conclusion Vascular calcification is present in the majority of KTCs. Calcification of the infrarenal aorta and iliac arteries may be assessed using CT-angiography, though higher calcium scores and lower volumes are found compared to the non-contrast CT scan.https://doi.org/10.1186/s42155-025-00542-1
spellingShingle Ola Sobhy A. Elmeseiny
Simon Winther
Hanne Skou Jørgensen
My Svensson
Morten Bøttcher
Per Ivarsen
Gratien Andersen
Henrik Birn
Marie Bodilsen Nielsen
Assessment of aortic and iliac artery calcification using CT-angiography in kidney transplant candidates
CVIR Endovascular
title Assessment of aortic and iliac artery calcification using CT-angiography in kidney transplant candidates
title_full Assessment of aortic and iliac artery calcification using CT-angiography in kidney transplant candidates
title_fullStr Assessment of aortic and iliac artery calcification using CT-angiography in kidney transplant candidates
title_full_unstemmed Assessment of aortic and iliac artery calcification using CT-angiography in kidney transplant candidates
title_short Assessment of aortic and iliac artery calcification using CT-angiography in kidney transplant candidates
title_sort assessment of aortic and iliac artery calcification using ct angiography in kidney transplant candidates
url https://doi.org/10.1186/s42155-025-00542-1
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