title: Accuracy of coronary computed tomography angiography vs intravascular ultrasound for evaluation of vessel area.
abstract: BACKGROUND
  We evaluated the accuracy of commonly used thresholds for vessel area evaluation on coronary CT angiography (CTA) and assessed ability of CTA to image the adventitial border.
  
  
  METHODS
  We evaluated 137 paired (coronary CTA and intravascular ultrasound [IVUS]) coronary artery cross-sections in 30 patients. CTA analysis included measurements of external vessel border area defined at Hounsfield unit (HU) thresholds of 0 (presumed adventitia), 50, and 70 (presumed external elastic membrane [EEM]). IVUS analysis included measurements of lumen, EEM, and outer border of the highly echogenic area adjacent to EEM (presumed adventitia area).
  
  
  RESULTS
  High correlation was found between CTA and IVUS measurements for EEM areas (R(2) = 0.65, P < .001 and R(2) = 0.60, P < .001 for CTA thresholds of 50 and 70 HU, respectively). CTA and IVUS measurements of adventitia areas were significantly correlated (R(2) = 0.74; P < .001), with no significant difference between the 2 methods (20.2 ± 6.4 mm(2) vs 19.8 ± 6.4 mm(2), respectively; P = .278). Cross-sectional coronary lumen radiodensity on CTA images and plaque burden measured on IVUS significantly affected the accuracy of CTA in assessment of the EEM area but not the presumed adventitial area.
  
  
  CONCLUSIONS
  We have demonstrated that use of a 50-HU threshold for vessel area determination by CTA led to its significant overestimation, whereas 70-HU threshold was close to that of EEM on IVUS. CTA may accurately delineate the coronary adventitial border by using a 0-HU threshold.
authors.affiliation: Coronary Disease and Structural Heart Diseases Department, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw, Poland; Invasive Cardiology and Angiology Department, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw, Poland. Electronic address: mkruk@ikard.pl.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Kruk
authors.affiliation: Coronary Disease and Structural Heart Diseases Department, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw, Poland; Invasive Cardiology and Angiology Department, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw, Poland.
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Wardziak
authors.affiliation: Cardiovascular Research Foundation, New York, New York.
authors.forename: Gary S
authors.initials: GS
authors.lastname: Mintz
authors.affiliation: Department of Cardiology, University of Giessen, Klinikstr. 33, 35392 Giessen, Germany; Department of Radiology, University of Giessen, Klinikstr. 33, 35392 Giessen, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Achenbach
authors.affiliation: Coronary Disease and Structural Heart Diseases Department, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw, Poland; Invasive Cardiology and Angiology Department, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Pręgowski
authors.affiliation: Coronary Disease and Structural Heart Diseases Department, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw, Poland; Invasive Cardiology and Angiology Department, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw, Poland.
authors.forename: Witold
authors.initials: W
authors.lastname: Rużyłło
authors.affiliation: Coronary Disease and Structural Heart Diseases Department, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw, Poland; Invasive Cardiology and Angiology Department, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw, Poland.
authors.forename: Zofia
authors.initials: Z
authors.lastname: Dzielińska
authors.affiliation: Coronary Disease and Structural Heart Diseases Department, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw, Poland; Invasive Cardiology and Angiology Department, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Demkow
authors.affiliation: Invasive Cardiology and Angiology Department, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw, Poland.
authors.forename: Adam
authors.initials: A
authors.lastname: Witkowski
authors.affiliation: Coronary Disease and Structural Heart Diseases Department, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw, Poland; Invasive Cardiology and Angiology Department, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw, Poland.
authors.forename: Cezary
authors.initials: C
authors.lastname: Kępka
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional
keywords: Atherosclerosis; Computed tomography; Coronary angiography; Coronary artery disease; Intravascular ultrasound; adventitia