About the Total Calcification Score (TCS)
The Total Calcification Score (TCS) is a quantitative measure used to assess the extent and severity of brain calcifications.[1] It involves analyzing specific brain locations for the presence and characteristics of calcifications. Each location is assigned a score based on a visual rating scale, and these scores are summed to produce the TCS. This tool helps illustrate how scores are assigned and totaled.
[1] Nicolas G, Pottier C, Charbonnier C, et al. Phenotypic spectrum of probable and genetically-confirmed idiopathic basal ganglia calcification. Brain. 2013;136(Pt 11):3395-3407. doi:10.1093/brain/awt255
A score is attributed for each location. If multiple calcifications are present in one location, the most severe score is attributed. The bone window setting and Hounsfield value are used to confirm hyperdensities as calcifications. Scores are then assigned using the "brain window setting" according to these definitions:
- Score 0: Absent calcification.
- Score 1: Punctate calcification.
- Score 2: Faint calcification (small calcified area, intermediate apparent density).
- Score 3: Moderate calcification (maximal apparent density, not covering a large proportion of the location).
- Score 4: Severe calcification (maximal apparent density, covering a large proportion of the location).
- Score 5: Severe (as score 4) and confluent with at least one severe calcification of an adjacent location (among other scored locations).