Clinical Feasibility of 3D Automated Coronary Atherosclerotic Plaque Quantification Algorithm on Coronary Computed Tomography Angiography: Comparison with Intravascular Ultrasound
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To evaluate the diagnostic performance of automated coronary atherosclerotic plaque quantification (QCT) by different users (expert/non-expert/automatic).
One hundred fifty coronary artery segments from 142 patients who underwent coronary computed tomography angiography (CCTA) and intravascular ultrasound (IVUS) were analyzed. Minimal lumen area (MLA), maximal lumen area stenosis percentage (%AS), mean plaque burden percentage (%PB), and plaque volume were measured semi-automatically by expert, non-expert, and fully automatic QCT analyses, and then compared to IVUS.
Between IVUS and expert QCT analysis, the correlation coefficients (r) for the MLA, %AS, %PB, and plaque volume were excellent: 0.89 (p < 0.001), 0.84 (p < 0.001), 0.91 (p < 0.001), and 0.94 (p < 0.001), respectively. There were no significant differences in the mean parameters (all p values >0.05) except %AS (p = 0.01). The automatic QCT analysis showed comparable performance to non-expert QCT analysis, showing correlation coefficients (r) of the MLA (0.80 vs. 0.82), %AS (0.82 vs. 0.80), %PB (0.84 vs. 0.73), and plaque volume (0.84 vs. 0.79) when they were compared to IVUS, respectively.
Fully automatic QCT analysis showed clinical utility compared with IVUS, as well as a compelling performance when compared with semiautomatic analyses.
• Coronary CTA enables the assessment of coronary atherosclerotic plaque.
• High-risk plaque characteristics and overall plaque burden can predict future cardiac events.
• Coronary atherosclerotic plaque quantification is currently unfeasible in practice.
• Quantitative computed tomography coronary plaque analysis software (QCT) enables feasible plaque quantification.
• Fully automatic QCT analysis shows excellent performance.
KeywordsCoronary atherosclerotic plaque Coronary computed tomography angiography Automatic quantification Plaque volume Intravascular ultrasound
Coronary computed tomography angiography
Quantitative computed tomography
Invasive coronary angiography
Coronary artery disease
Minimal lumen area
Minimal lumen diameter
Maximal lumen diameter stenosis percentage
Maximal lumen area stenosis percentage
Mean plaque burden percentage
The scientific guarantor of this publication is Hyuk-Jae Chang. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. This research was supported by the Leading Foreign Research Institute Recruitment Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (MSIP) (No. 2012027176). No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, diagnostic or prognostic study, multicenter study.
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