{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:30:48Z","timestamp":1787765448583,"version":"build-2784847793"},"reference-count":23,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T00:00:00Z","timestamp":1765411200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"St. Francis Hospital Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tomography"],"abstract":"<jats:p>Background\/Objectives: Aortic valve calcification is commonly evaluated using 3.0 mm true non-contrast (TNC) computed tomography (CT) images. This study evaluates the reproducibility of virtual non-contrast (VNC) reconstructions at different slice intervals using photon-counting detector CT (PCD-CT). Methods: In this retrospective study, we included 279 consecutive patients, who underwent PCD-CT for evaluation of native aortic valve between February 2023 and December 2023 with both TNC and VNC images at 3.0 and 1.5 mm slice intervals. Aortic valve calcium score (AVCS) and aortic valve calcium volume (AVCV) were compared between the two methods using paired t-tests. Agreement for continuous variables was assessed using inter-class coefficients (ICCs). Cohen\u2019s Kappa (\u03ba) was calculated to evaluate the agreement between different modalities in diagnosing severe AV calcification. Results: Compared to the standard, TNC images at 1.5 mm intervals showed higher AVCS (mean difference: \u2212290 \u00b1 418, p &lt; 0.001), with high reproducibility between techniques (CS: ICC 0.969, [IQR 0.962, 0.975]). Compared with reference, VNC showed no significant differences in AVCS at either slice intervals, with excellent reproducibility (3.0 mm, ICC 0.970 [0.963, 0.976]; 1.5 mm, ICC 0.971 [0.964, 0.977]). Compared to TNC 3.0 mm, strong concordance was observed using other reconstruction techniques in assessing severe AV calcification (\u03ba = 0.81 [95% CI: 0.74\u20130.88], 0.83 [95% CI: 0.76\u20130.90], and 0.83 [95% CI: 0.76\u20130.90] for TNC at 1.5 mm, VNC at 3.0 mm, and 1.5 mm, respectively), with low misclassification rates. Conclusions: Our study highlights high reproducibility in the evaluation of AVCS by VNC reconstruction at 3.0 and 1.5 mm intervals compared with reference offering a reliable alternative with an excellent diagnostic accuracy.<\/jats:p>","DOI":"10.3390\/tomography11120139","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T11:17:27Z","timestamp":1765451847000},"page":"139","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Aortic Valve Calcium Scoring Using True and Virtual Non-Contrast Reconstructions on Photon-Counting CT with Differing Slice Increments: Impact on Calcium Severity Classifications"],"prefix":"10.3390","volume":"11","author":[{"given":"Mandeep","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Cardiology, St Francis Hospital & Heart Center, Roslyn, NY 11576, USA"},{"name":"College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY 11568, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amirhossein","family":"Moaddab","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St Francis Hospital & Heart Center, Roslyn, NY 11576, USA"},{"name":"Division of Cardiovascular Imaging, St. Francis Hospital and Heart Center, Roslyn, NY 11576, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4960-5732","authenticated-orcid":false,"given":"Doosup","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St Francis Hospital & Heart Center, Roslyn, NY 11576, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6847-8057","authenticated-orcid":false,"given":"Jonathan","family":"Weber","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Imaging, St. Francis Hospital and Heart Center, Roslyn, NY 11576, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8160-2059","authenticated-orcid":false,"given":"Karen","family":"Chau","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St Francis Hospital & Heart Center, Roslyn, NY 11576, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6117-9970","authenticated-orcid":false,"given":"Ali H.","family":"Dakroub","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St Francis Hospital & Heart Center, Roslyn, NY 11576, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9986-3265","authenticated-orcid":false,"given":"Roosha","family":"Parikh","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St Francis Hospital & Heart Center, Roslyn, NY 11576, USA"},{"name":"College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY 11568, USA"},{"name":"Division of Cardiovascular Imaging, St. Francis Hospital and Heart Center, Roslyn, NY 11576, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karli","family":"Pipitone","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Imaging, St. Francis Hospital and Heart Center, Roslyn, NY 11576, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziad A.","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St Francis Hospital & Heart Center, Roslyn, NY 11576, USA"},{"name":"College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY 11568, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1850-8665","authenticated-orcid":false,"given":"Omar K.","family":"Khalique","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St Francis Hospital & Heart Center, Roslyn, NY 11576, USA"},{"name":"College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY 11568, USA"},{"name":"Division of Cardiovascular Imaging, St. Francis Hospital and Heart Center, Roslyn, NY 11576, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Scalia, I.G., Farina, J.M., Padang, R., Jokerst, C.E., Pereyra, M., Mahmoud, A.K., Naqvi, T.Z., Chao, C.-J., Oh, J.K., and Arsanjani, R. 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