This study aimed to validate an AI-based automatic coronary artery calcium (CAC) scoring system on non-ECG-gated low-dose chest computed tomography (LDCT) using multi-institutional datasets. The AVIEW CAC software from Coreline Soft was used to perform automatic CAC scoring on LDCT scans, showing good to excellent reliability in CAC score and CAC severity categorization. However, the reliability varied among institutions. Overall, the AI-based CAC scoring system demonstrated promising results in detecting CAC on LDCT scans across multiple institutions.
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