European Radiology

, Volume 20, Issue 8, pp 1841–1850

Quantitative assessment of stenosis severity and atherosclerotic plaque composition using 256-slice computed tomography

  • Grigorios Korosoglou
  • Dirk Mueller
  • Stephanie Lehrke
  • Henning Steen
  • Waldemar Hosch
  • Tobias Heye
  • Hans-Ulrich Kauczor
  • Evangelos Giannitsis
  • Hugo A. Katus
Cardiac

DOI: 10.1007/s00330-010-1753-3

Cite this article as:
Korosoglou, G., Mueller, D., Lehrke, S. et al. Eur Radiol (2010) 20: 1841. doi:10.1007/s00330-010-1753-3

Abstract

Objective

To quantitatively estimate lumen narrowing and to assess the volume and composition of atherosclerotic plaque with 256-slice computed tomography angiography (CTA), using conventional quantitative coronary angiography (QCA) as the gold standard.

Methods

Twenty-seven consecutive patients with suspected coronary artery disease (CAD) underwent 256-slice CTA and subsequent coronary angiography within 4 weeks. Quantification of lumen narrowing was performed on curved multiplanar reformatted CTA images, in identical projections to those used for QCA. Atherosclerotic plaque volume and composition were assessed by using commercially available software.

Results

The overall correlation between the stenosis severity by QCA compared with CTA was high (r2 = 0.79, p < 0.001). For the detection of ≥50% and ≥75% diameter lesions, CTA yielded high sensitivity, specificity and accuracy (86%, 95% and 90%; and 89%, 100% and 96%, respectively), using QCA as the standard reference. Furthermore, assessment of atherosclerotic plaque yielded highly reproducible results (inter-observer and intra-variability of 13% and 9%, respectively, for the assessment of plaque volume, and high agreement between observers (κ = 0.86) for the differentiation between non-calcified, mixed and calcified plaque).

Conclusions

Clinically indicated 256-slice CT angiography in symptomatic patients can aid both quantification of lumen narrowing and evaluation of atherosclerotic plaque, with high reproducibility.

Keywords

Atherosclerotic plaque Coronary lumen narrowing Cardiac computed tomography Quantitative coronary angiography 

Supplementary material

330_2010_1753_Fig1_ESM.gif (273 kb)
Fig. S1

Representative examples of a non-calcified (a) and of a mixed atherosclerotic coronary plaque (b) with their corresponding 2 and 3 Gaussian curves, respectively for different plaque components (GIF 273 KB)

330_2010_1753_Fig1_ESM.tif (557 kb)
High resolution image (TIF 557 KB)
330_2010_1753_Fig2_ESM.gif (264 kb)
Fig. S2

Overall image quality was higher for prospective compared with retrospective CTA, particularly in the coronary segments RCA 4, LAD 5, LAD 8 and LCX 12. This was possibly attributed to the lower heart rate in patients who underwent prospective CTA (57 ± 5 versus 75 ± 5 beats/min, p < 0.001) (GIF 263 KB)

330_2010_1753_Fig2_ESM.tif (296 kb)
High resolution image (TIF 296 KB)

Copyright information

© European Society of Radiology 2010

Authors and Affiliations

  • Grigorios Korosoglou
    • 1
  • Dirk Mueller
    • 2
  • Stephanie Lehrke
    • 1
  • Henning Steen
    • 1
  • Waldemar Hosch
    • 3
  • Tobias Heye
    • 3
  • Hans-Ulrich Kauczor
    • 3
  • Evangelos Giannitsis
    • 1
  • Hugo A. Katus
    • 1
  1. 1.Department of CardiologyUniversity of HeidelbergHeidelbergGermany
  2. 2.Philips GmbH Healthcare DivisionHamburgGermany
  3. 3.Department of RadiologyUniversity of HeidelbergHeidelbergGermany