Assessment of atherosclerotic carotid plaque volume with multidetector computed tomography angiography.
OBJECTIVE
The amount of atherosclerotic plaque and its components (calcifications, fibrous tissue, and lipid core) could be better predictors of acute events than the now currently used degree of stenosis. Therefore, we evaluated a dedicated software tool for volume measurements of atherosclerotic carotid plaque and its components in multidetector computed tomography angiography (MDCTA) images.


METHODS
Data acquisition was approved by the Institutional Review Board and all patients gave written informed consent. MDCTA images of 56 carotid arteries were analyzed by three observers. Plaque volumes were assessed by manual drawing of the outer vessel contour. The luminal boundary was determined based on a Hounsfield-Unit (HU) threshold. The contribution of different components was measured by the number of voxels within defined ranges of HU-values (calcification >130 HU, fibrous tissue 60-130 HU, lipid core <60 HU). Interobserver variability (IOV) was assessed.


RESULTS
Plaque volume was 1,259 +/- 621 mm3. The calcified, fibrous and lipid volumes were 238 +/- 252 mm3, 647 +/- 277 mm3 and 376 +/- 283 mm3, respectively. IOV was moderate with interclass correlation coefficients (ICC) ranging from 0.76 to 0.99 and coefficients of variation (COV) ranging from 3% to 47%.


CONCLUSIONS
Atherosclerotic carotid plaque volume and plaque component volumes can be assessed with MDCTA with a reasonable observer variability.
de Weert
Thomas T
TT
Department of Radiology, Erasmus MC, University Medical Center Rotterdam, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
de Monyé
Cécile
C
Meijering
Erik
E
Booij
Ronald
R
Niessen
Wiro J
WJ
Dippel
Diederik W J
DW
van der Lugt
Aad
A
D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D015588:Observer Variation; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D012984:Software; D014057:Tomography, X-Ray Computed / Q000379:methods*