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Assessment of carotid plaque composition using fast-kV switching dual-energy CT with gemstone detector: comparison with extracorporeal and virtual histology-intravascular ultrasound

  • Diagnostic Neuroradiology
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Abstract

Introduction

The present study compares the applicability of CT carotid plaque imaging using effective Z maps using gemstone spectral imaging (GSI) with that of conventional extracorporeal carotid ultrasound (US) and virtual histology-intravascular ultrasound (VH-IVUS).

Methods

We assessed stenosis in 31 carotid arteries of 30 patients. All patients underwent carotid CTA using GSI (Discovery CT750 HD, GE Healthcare). US and IVUS were examined with 25 and 8 vessels, respectively. We compared the effective Z values at noncalcified carotid plaque with the plaque components identified by US. We defined the plaque with low or low to iso intensity on US as vulnerable plaque and the plaque with iso, iso to high, and high intensity on US as stable plaque. We also performed visual assessment of color-coded effective Z maps in comparison with VH-IVUS and compared effective Z values with plaque components generated by VH-IVUS.

Results

The effective Z values at noncalcified carotid plaque were significantly lower for a group with vulnerable plaque, than with stable plaque on US (p < 0.05). Receiver operating curve analysis showed that AUC of effective Z values was 0.882 concerning the differentiation of these two groups on US. The interpretation of color-coded effective Z maps was essentially compatible with that of VH-IVUS for carotid plaque in all vessels. Effective Z values at noncalcified plaque showed significant negative correlation with the areas of fibro-fatty components generated by VH-IVUS (ρ = −0.874, p < 0.05).

Conclusion

Effective Z maps generated by GSI can detect vulnerable carotid plaque materials.

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Ethical standards and patient consent

This research project was approved by the appropriate Ethics Committee and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Although patient consent was waived for this retrospective study, GSI-CTA, US, and VH-IVUS studies were performed with informed consent of the patient or the patient’s relatives.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, 36-1, Nishi-cho, Yonago, 683-8504, Japan

    Yuki Shinohara, Keita Kuya, Yasutoshi Ohta, Shinya Fujii & Toshihide Ogawa

  2. Division of Neurosurgery, Department of Neurological Sciences, Faculty of Medicine, Tottori University, Yonago, Japan

    Makoto Sakamoto & Takashi Watanabe

  3. Division of Clinical Radiology, Tottori University Hospital, Yonago, Japan

    Junichi Kishimoto & Naoki Iwata

Authors
  1. Yuki Shinohara
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  2. Makoto Sakamoto
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  3. Keita Kuya
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  4. Junichi Kishimoto
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  6. Yasutoshi Ohta
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  8. Takashi Watanabe
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  9. Toshihide Ogawa
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Corresponding author

Correspondence to Yuki Shinohara.

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Shinohara, Y., Sakamoto, M., Kuya, K. et al. Assessment of carotid plaque composition using fast-kV switching dual-energy CT with gemstone detector: comparison with extracorporeal and virtual histology-intravascular ultrasound. Neuroradiology 57, 889–895 (2015). https://doi.org/10.1007/s00234-015-1541-5

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  • DOI: https://doi.org/10.1007/s00234-015-1541-5

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