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

Ola Sobhy A Elmeseiny; Simon Winther; Hanne Skou Jørgensen; My Svensson; Morten Bøttcher; Per Ivarsen; Gratien Andersen; Henrik Birn; Marie Bodilsen Nielsen

doi:10.1186/s42155-025-00542-1

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

Ola Sobhy A Elmeseiny, Simon Winther, Hanne Skou Jørgensen, My Svensson, Morten Bøttcher, Per Ivarsen, Gratien Andersen, Henrik Birn, Marie Bodilsen Nielsen

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

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.

Original language	English
Article number	39
Journal	CVIR endovascular
Volume	8
Issue	1
Pages (from-to)	39
ISSN	2520-8934
DOIs	https://doi.org/10.1186/s42155-025-00542-1
Publication status	Published - Dec 2025

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10.1186/s42155-025-00542-1

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@article{0a489f02e0a949799ecae5876a6d9b4c,

title = "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 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.",

author = "Elmeseiny, {Ola Sobhy A} and Simon Winther and J{\o}rgensen, {Hanne Skou} and My Svensson and Morten B{\o}ttcher and Per Ivarsen and Gratien Andersen and Henrik Birn and Nielsen, {Marie Bodilsen}",

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doi = "10.1186/s42155-025-00542-1",

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Assessment of aortic and iliac artery calcification using CT-angiography in kidney transplant candidates. / Elmeseiny, Ola Sobhy A; Winther, Simon ; Jørgensen, Hanne Skou et al.
In: CVIR endovascular, Vol. 8, No. 1, 39, 12.2025, p. 39.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Assessment of aortic and iliac artery calcification using CT-angiography in kidney transplant candidates

AU - Elmeseiny, Ola Sobhy A

AU - Winther, Simon

AU - Jørgensen, Hanne Skou

AU - Svensson, My

AU - Bøttcher, Morten

AU - Ivarsen, Per

AU - Andersen, Gratien

AU - Birn, Henrik

AU - Nielsen, Marie Bodilsen

PY - 2025/12

Y1 - 2025/12

N2 - 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.

AB - 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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U2 - 10.1186/s42155-025-00542-1

DO - 10.1186/s42155-025-00542-1

M3 - Journal article

C2 - 40327190

SN - 2520-8934

VL - 8

SP - 39

JO - CVIR endovascular

JF - CVIR endovascular

IS - 1

M1 - 39

ER -

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

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