Assessment of nonstenotic coronary lesions by 64-slice multidetector computed tomography in comparison to intravascular ultrasound: Evaluation of nonculprit coronary lesions

Petranovic, Milena; Soni, Anand; Bezzera, Hiram; Loureiro, Ricardo; Sarwar, Ammar; Raffel, Chris; Pomerantsev, Eugene; Jang, Ik-Kyung; Brady, Thomas J.; Achenbach, Stephan; Cury, Ricardo C.

doi:10.1016/j.jcct.2008.12.005

« Previous Next »Journal of Cardiovascular Computed Tomography
Volume 3, Issue 1 , Pages 24-31, January 2009

Assessment of nonstenotic coronary lesions by 64-slice multidetector computed tomography in comparison to intravascular ultrasound: Evaluation of nonculprit coronary lesions

Milena Petranovic, BA
- Department of Radiology, Massachusetts General Hospital, 165 Cambridge Street Suite 400, Boston, MA 02114, USA
Anand Soni, MD
- Department of Radiology, Massachusetts General Hospital, 165 Cambridge Street Suite 400, Boston, MA 02114, USA
Hiram Bezzera, MD
- Department of Radiology, Massachusetts General Hospital, 165 Cambridge Street Suite 400, Boston, MA 02114, USA
Ricardo Loureiro, MD
- Department of Radiology, Massachusetts General Hospital, 165 Cambridge Street Suite 400, Boston, MA 02114, USA
Ammar Sarwar, MD
- Department of Radiology, Massachusetts General Hospital, 165 Cambridge Street Suite 400, Boston, MA 02114, USA
Chris Raffel, MD
- Division of Cardiology, Massachusetts General Hospital, 165 Cambridge Street Suite 400, Boston, MA 02114, USA
Eugene Pomerantsev, MD, PhD
- Division of Cardiology, Massachusetts General Hospital, 165 Cambridge Street Suite 400, Boston, MA 02114, USA
Ik-Kyung Jang, MD
- Division of Cardiology, Massachusetts General Hospital, 165 Cambridge Street Suite 400, Boston, MA 02114, USA
Thomas J. Brady, MD
- Department of Radiology, Massachusetts General Hospital, 165 Cambridge Street Suite 400, Boston, MA 02114, USA
Stephan Achenbach, MD
- Department of Internal Medicine II (Cardiology), University of Erlangen, Erlangen, Germany
Ricardo C. Cury, MD
- Department of Radiology, Massachusetts General Hospital, 165 Cambridge Street Suite 400, Boston, MA 02114, USA
- Department of Radiology, Baptist (Miami) Cardiac and Vascular Institute, Miami, FL, USA
- Corresponding author.

Received 1 October 2008; accepted 15 December 2008. published online 25 December 2008.

Abstract

Background

Multidetector computed tomography (MDCT) has recently emerged as a potential noninvasive alternative for high-resolution imaging of coronary arteries.

Objective

In this study, we evaluated 64-slice MDCT for detection, quantification, and characterization of atherosclerotic plaque burden in nonculprit lesions.

Methods

Data from 11 patients who underwent both MDCT and intravascular ultrasound (IVUS) for suspected coronary artery disease were collected, and a total of 17 coronary segments and 122 cross-sectional slices were analyzed by MDCT and IVUS. Coronary segments on MDCT were coregistered to IVUS, and each obtained slice was scored by 2 blinded observers for presence and type of plaque. Quantitative measurements included cross-sectional vessel area, lumen area, wall area, plaque volume, and plaque burden. Mean and standard deviation of Hounsfield units (HUs) were recorded for plaque when present.

Results

Overall sensitivity for plaque detection was 95.0%, and specificity, positive predictive value, negative predictive value were 88.7%, 89.1%, and 94.8%, respectively. Spearman's correlation coefficients were 0.85, 0.75, 0.70, 0.89, and 0.54 for cross-sectional vessel area, lumen area, wall area, plaque volume, and plaque burden, respectively. The interobserver variability for plaque burden and plaque volume measurements between readers on 64-MDCT was high at 32.7% and 30.4%, respectively. Combined noncalcified plaque had a mean MDCT density significantly different from that of calcified plaque. Soft and fibrous plaques were not able to be distinguished based on their HU values.

Conclusion

Sixty-four–slice MDCT had good correlation with IVUS but with high interobserver variability. Plaque characterization remains a challenge with present MDCT technology.

Keywords: Atherosclerotic disease, Cardiac imaging, Intravascular ultrasound, Multidetector computed tomography, Plaque detection