title: Noninvasive Imaging of Atherosclerotic Plaque Progression: Status of Coronary Computed Tomography Angiography.
abstract: The process of coronary artery disease progression is infrequently visualized. Intravascular ultrasound has been used to gain important insights but is invasive and therefore limited to high-risk patients. For low-to-moderate risk patients, noninvasive methods may be useful to quantitatively monitor plaque progression or regression and to understand and personalize atherosclerosis therapy. This review discusses the potential for coronary computed tomography angiography to evaluate the extent and subtypes of coronary plaque. Computed tomographic technology is evolving and image quality of the method approaches the level required for plaque progression monitoring. Methods to quantify plaque on computed tomography angiography are reviewed as well as a discussion of their use in clinical trials. Limitations of coronary computed tomography angiography compared with competing modalities include limited evaluation of plaque subcomponents and incomplete knowledge of the value of the method especially in patients with low-to-moderate cardiovascular risk.
authors.affiliation: From the Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (V.S., D.A.B.); and Department of Radiology (J.A.C.L.) and Cardiology Division, Department of Medicine (J.A.C.L.), Johns Hopkins University, Baltimore, MD.
authors.forename: Veit
authors.initials: V
authors.lastname: Sandfort
authors.affiliation: From the Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (V.S., D.A.B.); and Department of Radiology (J.A.C.L.) and Cardiology Division, Department of Medicine (J.A.C.L.), Johns Hopkins University, Baltimore, MD.
authors.forename: Joao A C
authors.initials: JA
authors.lastname: Lima
authors.affiliation: From the Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (V.S., D.A.B.); and Department of Radiology (J.A.C.L.) and Cardiology Division, Department of Medicine (J.A.C.L.), Johns Hopkins University, Baltimore, MD. bluemked@cc.nih.gov.
authors.forename: David A
authors.initials: DA
authors.lastname: Bluemke
mesh_terms: D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000473:pathology; D018450:Disease Progression; D006801:Humans; D018810:Magnetic Resonance Angiography; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional
keywords: atherosclerosis; coronary artery disease; inflammation; myocardial infarction; plaque, atherosclerotic