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Quantification and characterisation of coronary artery plaque volume and adverse plaque features by coronary computed tomographic angiography: a direct comparison to intravascular ultrasound

  • Cardiac
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Abstract

Objective

We evaluated the performance of manual measures of coronary plaque volumes and atherosclerotic plaque features from coronary CT angiography (CTA), using intravascular ultrasound (IVUS) as the reference.

Methods

Thirty individual coronary plaques with suitable fiduciary markers were identified. Plaque volumes on coronary CTA were manually quantified by two observers and compared to IVUS plaque volumes as interpreted by an independent laboratory. The presence of adverse plaque characteristics—low attenuation plaque (LAP), positive remodelling (PR) and spotty calcification (SC)—on coronary CTA was evaluated and compared to IVUS.

Results

High correlation in plaque volumes was detected between observers (r = 0.94, P < 0.0001; 95 % limits of agreement <48.7 mm3, bias 6.6 mm3). Excellent correlation (r = 0.95, P < 0.0001) was noted in plaque volume between independent observers and IVUS (95 % limits of agreement <40.6 mm3, bias −4.4 mm3) and did not differ from IVUS (105.0 ± 56.7 vs. 109.4 ± 60.7 mm3, P = 0.2). The frequency of LAP (10 % vs. 17 %), PR (7 % vs. 10 %) and SC (27 % vs. 33 %) was similar between coronary CTA and IVUS (all P = NS).

Conclusions

Plaque volume on coronary CTA determined by manual methods demonstrates high correlation and modest agreement to IVUS. Further, coronary CTA demonstrates high accuracy for the identification of adverse plaque characteristics, including LAP, PR and SC.

Key Points

• Coronary CT angiography is a non-invasive test that enables coronary plaque assessment

• Plaque quantification by coronary CT angiography correlates well with intravascular ultrasound findings

• Coronary CT angiography can identify adverse plaque characteristics

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Abbreviations

Coronary CTA:

Coronary computed tomographic angiography

ICA:

Invasive coronary angiography

IVUS:

Intravascular ultrasound

LAD:

Left anterior descending artery

LAP:

Low attenuation plaque

LCX:

Left circumflex artery

MACE:

Major adverse cardiac events

PR:

Positive arterial remodelling

RCA:

Right coronary artery

SC:

Spotty calcification

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Authors and Affiliations

  1. Departments of Imaging (Division of Nuclear Medicine) and Medicine (Division of Cardiology), Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, S. Mark Taper Building, Suite 1258, Los Angeles, CA, 90048, USA

    Ryo Nakazato, Aryeh Shalev, Damini Dey, Daniel S. Berman & James K. Min

  2. Department of Medicine, Inje University Ilsan-Paik Hospital, Goyang, South Korea

    Joon-Hyung Doh

  3. Department of Medicine, Seoul National University Hospital, Seoul, South Korea

    Bon-Kwon Koo

Authors
  1. Ryo Nakazato
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  2. Aryeh Shalev
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  4. Bon-Kwon Koo
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  5. Damini Dey
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  7. James K. Min
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Correspondence to James K. Min.

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Nakazato, R., Shalev, A., Doh, JH. et al. Quantification and characterisation of coronary artery plaque volume and adverse plaque features by coronary computed tomographic angiography: a direct comparison to intravascular ultrasound. Eur Radiol 23, 2109–2117 (2013). https://doi.org/10.1007/s00330-013-2822-1

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  • DOI: https://doi.org/10.1007/s00330-013-2822-1

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