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How reliable are 40 MHz IVUS and 64-slice MDCT in characterizing coronary plaque composition? An ex vivo study with histopathological comparison

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Abstract

The present study investigated whether IVUS could serve as a reliable reference in validating MDCT characterization of coronary plaque against a histological gold standard. Twenty-one specimens were postmortem human coronary arteries. Coronary cross-sections were imaged by 40 MHz IVUS and by 64-slice MDCT and characterized histologically as presenting calcified, fibrous or lipid-rich plaques. Plaque composition was analyzed visually and intra-plaque MDCT attenuation was measured in Hounsfield Units (HU). 83 atherosclerotic plaques were identified. IVUS failed to characterize calcified plaque accurately, with a positive predictive value (ppv) of 75% versus 100% for MDCT. Lipid-rich plaque was even less accurately characterized, with ppv of 60 and 68% for IVUS and MDCT respectively. Mean MDCT attenuation was 966 ± 473 HU for calcified plaque, 83 ± 35 HU for fibrous plaque and 70.92 HU ± 41 HU for lipid-rich plaque. No significant difference in mean MDCT attenuation was found between fibrous and lipid-rich plaques (P = 0.276). In vivo validation of MDCT against an IVUS reference thus appears to be an unsuitable and unreliable approach: 40 MHz IVUS suffers from acoustic ambiguities in plaque characterization, and 64-slice MDCT fails to analyze plaque morphology and components accurately.

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Authors and Affiliations

  1. Department of Interventional Cardiology, Cardiovascular Hospital and Claude Bernard University, INSERM Research Unit 886 and CREATIS Research Unit associated to CNRS (UMR 5515), B.P Lyon-Monchat, 69394, Lyon Cedex 03, France

    Romain Chopard, Pascal Motreff, Gilles Rioufol & Gérard Finet

  2. Department of Radiology, Cardiovascular Hospital and Claude Bernard University, INSERM Research Unit 886 and CREATIS Research Unit associated to CNRS (UMR 5515), Lyon, France

    Loic Boussel, Philippe Douek & Didier Revel

  3. Department of Pathology, Cardiovascular Hospital and Claude Bernard University, INSERM Research Unit 886 and CREATIS Research Unit associated to CNRS (UMR 5515), Lyon, France

    Alain Tabib & David Meyronet

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  1. Romain Chopard
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  2. Loic Boussel
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  3. Pascal Motreff
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  4. Gilles Rioufol
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  5. Alain Tabib
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  6. Philippe Douek
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  7. David Meyronet
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  8. Didier Revel
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  9. Gérard Finet
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Correspondence to Gérard Finet.

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Chopard, R., Boussel, L., Motreff, P. et al. How reliable are 40 MHz IVUS and 64-slice MDCT in characterizing coronary plaque composition? An ex vivo study with histopathological comparison. Int J Cardiovasc Imaging 26, 373–383 (2010). https://doi.org/10.1007/s10554-009-9562-y

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  • DOI: https://doi.org/10.1007/s10554-009-9562-y

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