Calcium scoring using virtual non-contrast images from a dual-layer spectral detector CT: comparison to true non-contrast data and evaluation of proportionality factor in a large patient collective.

• Calcium scoring is feasible from contrast-enhanced CT images using a dual-layer spectral detector CT scanner. • When multiplied by a correction factor, calcium scoring from virtual non-contrast images shows good agreement with the standard technique. • Omitting native scans for calcium scoring could enable radiation dose reduction.