29 Dec 20. Featured Paper

Link to paper on Journal of Cardiovascular Computed Tomography

 

Authors

Mohammed N. Meah, Trisha Singh, Michelle C. Williams, Marc R. Dweck, David E. Newby, Piotr Slomka, Philip D. Adamson, Alastair J. Moss, Damini Dey

 

Abstract

Background: The ability to characterize & to quantify the extent of coronary artery disease has the potential to improve the prognostic capability of coronary computed tomography angiography.

Although reproducible techniques have been described in those with mild coronary disease, this has yet to be assessed in patients with advanced disease.

Methods: Twenty patients with known multivessel disease underwent repeated computed tomography coronary angiography, 2 weeks apart.

Coronary artery segments were analysed using semi-automated software by two trained observers to determine intraobserver, interobserver & interscan reproducibility.

Results: Overall, 149 coronary arterial segments were analysed.

There was excellent intraobserver & interobserver agreement for all plaque volume measurements (Lin’s coefficient 0.95 to 1.0).

There were no substantial interscan differences (P ​> ​0.05 for all) for total (2063 ​± ​1246 ​mm³, mean of differences −35.6 ​mm³), non-calcified (1795 ​± ​910 ​mm³, mean of differences −4.3 ​mm³), calcified (298 ​± ​425 ​mm³, mean of differences −31.3 ​mm³) & low-attenuation (13 ​± ​13 ​mm³, mean of differences −2.6 ​mm³) plaque volumes.

Interscan agreement was highest for total & noncalcified plaque volumes.

Calcified & low-attenuation plaque (−236.6 to 174 mm³ & -15.8 to 10.5 ​mm³ respectively) had relatively wider 95% limits of agreement reflecting the lower absolute plaque volumes.

Conclusion: In the presence of advanced coronary disease, semi-automated plaque quantification provides excellent reproducibility, particularly for total & non-calcified plaque volumes.

This approach has major potential to assess change in disease over time & optimize risk stratification in patients with established coronary artery disease.

 

Keywords

• Atherosclerosis

• Computed tomography coronary angiography

• Low-attenuation plaque

• Quantitative plaque analysis

• Reproducibility