title: Lumen and calcium characteristics within calcified coronary lesions. Comparison of computed tomography coronary angiography versus intravascular ultrasound.
abstract: BACKGROUND
  Computed tomography coronary angiography (CTCA) is a diagnostic method used for exclusion of coronary artery disease. However, lower accuracy of CTCA in assessment of calcified lesions is a significant factor impeding applicability of CTCA for assessment of coronary atherosclerosis.
  
  
  OBJECTIVE
  To provide insight into lumen and calcium characteristics assessed with CTCA, we compared these parameters to the reference of intravascular ultrasound (IVUS).
  
  
  METHODS
  Two hundred and fifty-two calcified lesions within 97 arteries of 60 patients (19 women, age 63 ±10 years) underwent assessment with both 2 × 64 slice CT (Somatom Definition, Siemens) and IVUS (s5, Volcano Corp.). Coronary lumen and calcium dimensions within calcified lesions were assessed with CTCA and compared to the reference measurements made with IVUS.
  
  
  RESULTS
  On average CTCA underestimated mean lumen diameter (2.8 ±0.7 mm vs. 2.9 ±0.8 mm for IVUS), lumen area (6.4 ±3.4 mm(2) vs. 7.0 ±3.7 mm(2) for IVUS, p < 0.001) and total calcium arc (52 ±35° vs. 83 ±54°). However, analysis of tertiles of the examined parameters revealed that the mean lumen diameter, lumen area and calcium arc did not significantly differ between CTCA and IVUS within the smallest lumens (1(st) tertile of mean lumen diameter at 2.1 mm, and 1(st) tertile of lumen area at 3.7 mm(2)) and lowest calcium arc (mean of 40°).
  
  
  CONCLUSIONS
  Although, on average, CTCA underestimates lumen diameter and area as well as calcium arc within calcified lesions, the differences are not significant within the smallest vessels and calcium arcs. The low diagnostic accuracy of CTCA within calcified lesions may be attributed to high variance and not to systematic error of measurements.
authors.affiliation: Institute of Cardiology, Warsaw, Poland.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Noll
authors.affiliation: Coronary Disease and Structural Heart Diseases Department, Institute of Cardiology, Warsaw, Poland.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Kruk
authors.affiliation: Invasive Cardiology and Angiology Department, Institute of Cardiology, Warsaw, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Pręgowski
authors.affiliation: Coronary Disease and Structural Heart Diseases Department, Institute of Cardiology, Warsaw, Poland.
authors.forename: Edyta
authors.initials: E
authors.lastname: Kaczmarska
authors.affiliation: Coronary Disease and Structural Heart Diseases Department, Institute of Cardiology, Warsaw, Poland.
authors.forename: Karolina
authors.initials: K
authors.lastname: Kryczka
authors.affiliation: Coronary Disease and Structural Heart Diseases Department, Institute of Cardiology, Warsaw, Poland.
authors.forename: Radosław
authors.initials: R
authors.lastname: Pracoń
authors.affiliation: Coronary Disease and Structural Heart Diseases Department, Institute of Cardiology, Warsaw, Poland.
authors.forename: Mirosław
authors.initials: M
authors.lastname: Skwarek
authors.affiliation: Coronary Disease and Structural Heart Diseases Department, Institute of Cardiology, Warsaw, Poland.
authors.forename: Zofia
authors.initials: Z
authors.lastname: Dzielińska
authors.affiliation: Coronary Disease and Structural Heart Diseases Department, Institute of Cardiology, Warsaw, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Petryka
authors.affiliation: Coronary Disease and Structural Heart Diseases Department, Institute of Cardiology, Warsaw, Poland.
authors.forename: Mateusz
authors.initials: M
authors.lastname: Spiewak
authors.affiliation: Coronary Disease and Structural Heart Diseases Department, Institute of Cardiology, Warsaw, Poland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Lubiszewska
authors.affiliation: Coronary Disease and Structural Heart Diseases Department, Institute of Cardiology, Warsaw, Poland.
authors.forename: Bożena
authors.initials: B
authors.lastname: Norwa-Otto
authors.affiliation: Invasive Cardiology and Angiology Department, Institute of Cardiology, Warsaw, Poland.
authors.forename: Maksymilian
authors.initials: M
authors.lastname: Opolski
authors.affiliation: Invasive Cardiology and Angiology Department, Institute of Cardiology, Warsaw, Poland.
authors.forename: Adam
authors.initials: A
authors.lastname: Witkowski
authors.affiliation: Coronary Disease and Structural Heart Diseases Department, Institute of Cardiology, Warsaw, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Demkow
authors.affiliation: Institute of Cardiology, Warsaw, Poland.
authors.forename: Witold
authors.initials: W
authors.lastname: Rużyłło
authors.affiliation: Coronary Disease and Structural Heart Diseases Department, Institute of Cardiology, Warsaw, Poland.
authors.forename: Cezary
authors.initials: C
authors.lastname: Kępka
keywords: computed tomography; coronary angiography; coronary artery disease; intravascular ultrasound