title: Diagnostic accuracy of dual-source computed tomography in the characterization of coronary atherosclerotic plaques: comparison with intravascular optical coherence tomography.
abstract: BACKGROUND
  Dual-source computed tomography (DSCT) has enabled us to non-invasively visualize coronary artery stenosis, but its ability to characterize coronary atherosclerotic plaques (ASPs) has not been evaluated. Intravascular optical coherence tomography (OCT) provides tissue images of coronary artery wall that are validated by pathohistological studies. We studied the diagnostic accuracy of DSCT in the characterization of coronary ASPs, especially lipid-rich ASP with thin fibrous cap (TCFA), in comparison with OCT.
  
  
  METHODS
  DSCT and OCT were used to image non-stenotic ASPs in non-culprit coronary arteries of 17 acute coronary syndrome (ACS) patients, and 162 coronary regions were enrolled.
  
  
  RESULTS
  The mean CT values of fibrous ASP, ASP with lipid core, and ASP with calcium deposit were 77.5, 28.9, and 515.9 HU, respectively (P<0.0001). ASP with calcium deposit was detected with a sensitivity of 88.9% and a specificity of 98.6%, while ASP with lipid core was detected by DSCT with a relatively low sensitivity of 73.1% and a high specificity of 94.0%. In TCFA, cross-sectional areas of both ASP and lipid core were significantly larger, mean CT value of ASP was significantly lower, and concomitant calcification was more frequently observed compared with lipid-rich ASP with thick fibrous cap (ThCFA). The combination of these CT parameters seems to be a useful index for the differentiation of TCFA from ThCFA.
  
  
  CONCLUSIONS
  DSCT is useful for non-invasive evaluation of calcified and fibro-fatty tissue characters in coronary artery plaque, but it is still not able to differentiate TCFA, one of the features of vulnerable plaque.
authors.affiliation: First Department of Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
authors.forename: Tsunenari
authors.initials: T
authors.lastname: Soeda
authors.forename: Shiro
authors.initials: S
authors.lastname: Uemura
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Morikawa
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Ishigami
authors.forename: Satoshi
authors.initials: S
authors.lastname: Okayama
authors.forename: Sung Ji
authors.initials: SJ
authors.lastname: Hee
authors.forename: Taku
authors.initials: T
authors.lastname: Nishida
authors.forename: Kenji
authors.initials: K
authors.lastname: Onoue
authors.forename: Satoshi
authors.initials: S
authors.lastname: Somekawa
authors.forename: Yukiji
authors.initials: Y
authors.lastname: Takeda
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kawata
authors.forename: Manabu
authors.initials: M
authors.lastname: Horii
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Saito
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000175:diagnosis* / Q000503:physiopathology; D041623:Tomography, Optical Coherence / Q000592:standards*; D014057:Tomography, X-Ray Computed / Q000592:standards*