Assessment of nonstenotic coronary lesions by 64-slice multidetector computed tomography in comparison to intravascular ultrasound: Evaluation of nonculprit coronary lesions

Abstract Background Multidetector computed tomography (MDCT) has recently emerged as a potential noninvasive alternative for high-resolution imaging of coronary arteries. Objective In this study, we evaluated 64-slice MDCT for detection, quantification, and characterization of atherosclerotic plaque...

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Published in:	Journal of cardiovascular computed tomography 2009, Vol.3 (1), p.24-31
Main Authors:	Petranovic, Milena, BA, Soni, Anand, MD, Bezzera, Hiram, MD, Loureiro, Ricardo, MD, Sarwar, Ammar, MD, Raffel, Chris, MD, Pomerantsev, Eugene, MD, PhD, Jang, Ik-Kyung, MD, Brady, Thomas J., MD, Achenbach, Stephan, MD, Cury, Ricardo C., MD
Format:	Article
Language:	eng
Subjects:	Atherosclerotic disease Cardiac imaging Cardiovascular Carotid Stenosis - diagnostic imaging Coronary Angiography - methods Echocardiography - methods Humans Intravascular ultrasound Multidetector computed tomography Plaque detection Reproducibility of Results Sensitivity and Specificity Tomography, X-Ray Computed - methods
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Summary:	Abstract Background Multidetector computed tomography (MDCT) has recently emerged as a potential noninvasive alternative for high-resolution imaging of coronary arteries. Objective In this study, we evaluated 64-slice MDCT for detection, quantification, and characterization of atherosclerotic plaque burden in nonculprit lesions. Methods Data from 11 patients who underwent both MDCT and intravascular ultrasound (IVUS) for suspected coronary artery disease were collected, and a total of 17 coronary segments and 122 cross-sectional slices were analyzed by MDCT and IVUS. Coronary segments on MDCT were coregistered to IVUS, and each obtained slice was scored by 2 blinded observers for presence and type of plaque. Quantitative measurements included cross-sectional vessel area, lumen area, wall area, plaque volume, and plaque burden. Mean and standard deviation of Hounsfield units (HUs) were recorded for plaque when present. Results Overall sensitivity for plaque detection was 95.0%, and specificity, positive predictive value, negative predictive value were 88.7%, 89.1%, and 94.8%, respectively. Spearman's correlation coefficients were 0.85, 0.75, 0.70, 0.89, and 0.54 for cross-sectional vessel area, lumen area, wall area, plaque volume, and plaque burden, respectively. The interobserver variability for plaque burden and plaque volume measurements between readers on 64-MDCT was high at 32.7% and 30.4%, respectively. Combined noncalcified plaque had a mean MDCT density significantly different from that of calcified plaque. Soft and fibrous plaques were not able to be distinguished based on their HU values. Conclusion Sixty-four–slice MDCT had good correlation with IVUS but with high interobserver variability. Plaque characterization remains a challenge with present MDCT technology.
ISSN:	1934-5925 1876-861X