Quantification of coronary plaque by 64-slice computed tomography: a comparison with quantitative intracoronary ultrasound.
BACKGROUND
Noninvasive assessment of coronary atherosclerotic plaque may be useful for risk stratification and treatment of atherosclerosis.


METHODS
We studied 47 patients to investigate the accuracy of coronary plaque volume measurement acquired with 64-slice multislice computed tomography (MSCT), using newly developed quantification software, when compared with quantitative intracoronary ultrasound (QCU). Quantitative MSCT coronary angiography (QMSCT-CA) was performed to determine plaque volume for a matched region of interest (regional plaque burden) and in significant plaque defined as a plaque with > or =50% area obstruction in QCU, and compared with QCU. Dataset with image blurring and heavy calcification were excluded from analysis.


RESULTS
In 100 comparable regions of interest, regional plaque burden was highly correlated (coefficient r = 0.96; P < 0.001) between QCU and QMSCT-CA, but QMSCT-CA overestimated the plaque burden by a mean difference of 7 +/- 33 mm3 (P = 0.03). In 76 significant plaques detected within the regions of interest, plaque volume determined by QMSCT-CA was highly correlated (r = 0.98; P < 0.001) with a slight underestimation of 2 +/- 17 mm3 (P = not significant) when compared with QCU. Calcified and mixed plaque volume was slightly overestimated by 4 +/- 19 mm3 (P = ns) and noncalcified plaque volume was significantly underestimated by 9 +/- 11 mm3 (P < 0.001) with QMSCT-CA. Overall, the limits of agreement for plaque burden/volume measurement between QCU and QMSCT-CA were relatively large. Reproducibility for the measurements of regional plaque burden with QMSCT-CA was good, with a mean intraobserver and interobserver variability of 0% +/- 16% and 4% +/- 24%, respectively.


CONCLUSIONS
Quantification of coronary plaque within selected proximal or middle coronary segments without image blurring and heavy calcification with 64-slice CT was moderately accurate with respect to intravascular ultrasound and demonstrated good reproducibility. Further improvement in CT resolution is required for more reliable measurement of coronary plaques using quantification software.
Otsuka
Masato
M
Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands.
Bruining
Nico
N
Van Pelt
Niels C
NC
Mollet
Nico R
NR
Ligthart
Jurgen M R
JM
Vourvouri
Eleni
E
Hamers
Ronald
R
De Jaegere
Peter
P
Wijns
William
W
Van Domburg
Ron T
RT
Stone
Gregg W
GW
Veldhof
Susan
S
Verheye
Stefan
S
Dudek
Dariusz
D
Serruys
Patrick W
PW
Krestin
Gabriel P
GP
De Feyter
Pim J
PJ
D003287:Contrast Media / Q000008:administration & dosage; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000175:diagnosis*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007479:Iopamidol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000379:methods; D015203:Reproducibility of Results; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D018084:Ultrasonography, Interventional / Q000379:methods*
D003287:Contrast Media; C057937:iomeprol; D007479:Iopamidol