title: Detection and quantification of coronary atherosclerotic plaque by 64-slice multidetector CT: a systematic head-to-head comparison with intravascular ultrasound.
abstract: OBJECTIVE
  We evaluated the ability of 64-slice multidetector computed tomography (MDCT)-derived plaque parameters to detect and quantify coronary atherosclerosis, using intravascular ultrasound (IVUS) as the reference standard.
  
  
  METHODS
  In 32 patients, IVUS and 64-MDCT was performed. The MDCT and IVUS datasets of 44 coronary arteries were co-registered using a newly developed fusion technique and quantitative parameters were derived from both imaging modalities. The threshold of >0.5 mm of maximum wall thickness was used to establish plaque presence on MDCT and IVUS.
  
  
  RESULTS
  We analyzed 1364 coregistered 1-mm coronary cross-sections and 255 segments of 5-mm length. Compared with IVUS, 64-MDCT enabled correct detection in 957 of 1109 cross-sections containing plaque (sensitivity 86%). In 180 of 255 cross-sections atherosclerosis was correctly excluded (specificity 71%). On the segmental level, MDCT detected 213 of 220 segments with any atherosclerotic plaque (sensitivity 96%), whereas the presence of any plaque was correctly ruled out in 28 of 32 segments (specificity 88%). Interobserver agreement for the detection of atherosclerotic cross-sections was moderate (Cohen's kappa coefficient K=0.51), but excellent for the atherosclerotic segments (K=1.0). Pearson's correlation coefficient for vessel plaque volumes measured by MDCT and IVUS was r=0.91 (p<0.001). Bland-Altman analysis showed a slight non-significant underestimation of any plaque volume by MDCT (p=0.5), with a trend to underestimate noncalcified and overestimate mixed/calcified plaque volumes (p=0.22 and p=0.87 respectively).
  
  
  CONCLUSIONS
  MDCT is able to detect and quantify atherosclerotic plaque. Further improvement in CT resolution is necessary for more reliable assessment of very small and distal coronary plaques.
authors.affiliation: Department of Cardiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands. elpa98@gmail.com
authors.forename: Stella-Lida
authors.initials: SL
authors.lastname: Papadopoulou
authors.forename: Lisan A
authors.initials: LA
authors.lastname: Neefjes
authors.forename: Michiel
authors.initials: M
authors.lastname: Schaap
authors.forename: Hui-Ling
authors.initials: HL
authors.lastname: Li
authors.forename: Ermanno
authors.initials: E
authors.lastname: Capuano
authors.forename: Alina G
authors.initials: AG
authors.lastname: van der Giessen
authors.forename: Johan C H
authors.initials: JC
authors.lastname: Schuurbiers
authors.forename: Frank J H
authors.initials: FJ
authors.lastname: Gijsen
authors.forename: Anoeshka S
authors.initials: AS
authors.lastname: Dharampal
authors.forename: Koen
authors.initials: K
authors.lastname: Nieman
authors.forename: Robert Jan
authors.initials: RJ
authors.lastname: van Geuns
authors.forename: Nico R
authors.initials: NR
authors.lastname: Mollet
authors.forename: Pim J
authors.initials: PJ
authors.lastname: de Feyter
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging*; D002114:Calcinosis / Q000000981:diagnostic imaging; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging*; D014463:Ultrasonography