Present invention relates to devices and methods for determining a calcium content by analyzing cardiac spectral CT data. CT projection data (9), obtainable by scanning a cardiac region of a subject using a spectral CT scanning unit, is modelled (12) by applying a material decomposition algorithm to the projection data to provide a calcium-specific component. Tomographic reconstructions (13) of the projection data, to provide a first 3D image (8), and of the calcium-specific component, to provide a second 3D image (6), are performed. The first 3D image (8) is segmented (14) to provide an image mask (5) corresponding to a cardiovascular structure of interest, a part of the second 3D image (6) is selected (15) based on the image mask (5), and a calcium content is calculated (16) in the cardiovascular structure of interest based on the selected part of the second 3D image (6).