Coronary Plaque Analysis for CT Angiography Clinical Research

Denzinger, Felix; Wels, Michael; Hopfgartner, Christian; Lü, Jing; Schöbinger, Max; Maier, Andreas; Sühling, Michael

doi:10.1007/978-3-658-33198-6_53

Cited by 4 publications

(4 citation statements)

References 13 publications

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“…CCTA with spectral information enables the computation of virtual noniodine images (PureCalcium), potentially obviating the need for true noncontrast scans ( 28 ) and for the reconstruction of images with a virtual, dual energy-based removal of calcified plaques (PureLumen), potentially facilitating coronary artery stenosis assessment ( 29 ). The spectral mode enables also the dual energy-based characterization of plaque components ( 20 ), which would be a potential advantage compared with the ultra-high-resolution mode. In an experimental study, PCD-CT operated in a multi-energy mode even allowed for the detection and quantification of the macrophage burden within calcified atherosclerotic plaques using gold nanoparticles ( 30 ).…”

Section: Discussionmentioning

confidence: 99%

“…Quantitative evaluation of atherosclerotic plaques was performed using a semiautomatic software (CT Coronary Plaque Analysis, software version 5.0.2, Syngo.via VB60A, Siemens Healthcare GmbH; Forchheim, Germany) ( 20 ), previously evaluated by Tesche et al ( 21 ). After automatic centerline extraction of the coronary arteries, one trained reader (V.M., resident with three years of experience in cardiovascular imaging) manually defined the proximal and the distal aspect of the coronary artery segment with atherosclerotic plaque.…”

Section: Methodsmentioning

confidence: 99%

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First in-human quantitative plaque characterization with ultra-high resolution coronary photon-counting CT angiography

Mergen

Eberhard

Manka

et al. 2022

Front. Cardiovasc. Med.

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PurposeTo assess the effect of ultra-high-resolution coronary CT angiography (CCTA) with photon-counting detector (PCD) CT on quantitative coronary plaque characterization.Materials and methodsIn this IRB-approved study, 22 plaques of 20 patients (7 women; mean age 77 ± 8 years, mean body mass index 26.1 ± 3.6 kg/m2) undergoing electrocardiography (ECG)-gated ultra-high-resolution CCTA with PCD-CT were included. Images were reconstructed with a smooth (Bv40) and a sharp (Bv64) vascular kernel, with quantum iterative reconstruction (strength level 4), and using a slice thickness of 0.6, 0.4, and 0.2 mm, respectively (field-of-view 200 mm × 200 mm, matrix size 512 × 512 pixels). Reconstructions with the Bv40 kernel and slice thickness of 0.6 mm served as the reference standard. After identification of a plaque in coronary arteries with a vessel diameter ≥2 mm, plaque composition was determined using a dedicated, semi-automated plaque quantification software. Total plaque, calcified, fibrotic, and lipid-rich plaque components were quantified in all datasets.ResultsMedian plaque volume was highest (23.5 mm3, interquartiles 17.9–34.3 mm3) for reconstructions with the reference standard and lowest for ultra-high-resolution reconstructions with a slice thickness of 0.2 mm and the Bv64 kernel (18.1 mm3, interquartiles 14.1–25.8 mm3, p < 0.001). Reconstructions with the reference standard showed largest calcified (85.1%, interquartiles 76.4–91.1%) and smallest lipid-rich plaque components (0.5%, interquartiles 0.0–1.5%). Smallest calcified plaque components (75.2%, interquartiles 69.9–80.8%) and largest lipid-rich components (6.7%, interquartiles 5.1–8.4%) were found for ultra-high-resolution reconstructions with a slice thickness of 0.2 mm and the Bv64 kernel. At an identical slice thickness, volume of calcified components was always lower, and volume of lipid-rich components was always higher for reconstructions with the Bv64 kernel compared with reconstructions with the Bv40 kernel (all, p < 0.001).ConclusionThis patient study indicates significant differences of ultra-high-resolution scanning with PCD-CT on quantitative coronary plaque characterization. Reduced blooming artifacts may allow improved visualization of fibrotic and lipid-rich plaque components with the ultra-high-resolution mode of PCD-CT.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

First in-human quantitative plaque characterization with ultra-high resolution coronary photon-counting CT angiography

Mergen

Eberhard

Manka

et al. 2022

Front. Cardiovasc. Med.

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“…We performed perivascular epicardial fat analysis (PVAT) in a semi-automated manner using a prototype post-processing and analytic software (Fig. 2, Coronary Plaque Analysis, syngo via Frontier, Siemens Healthineers) [19,20]. PVAT was analyzed around the proximal left anterior descending (LAD), right coronary artery (RCA), and left circumflex artery (LCx) using a previously described and validated methodology [21].…”

Section: Cardiac Ct and Perivascular Fat Analysismentioning

confidence: 99%

Evaluation of perivascular fat attenuation with coronary CT angiography in cardiac transplantation patients: an imaging biomarker candidate for prediction of cardiac mortality and re-transplantation

et al. 2023

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Objectives In cardiac transplant recipients, non-invasive allograft surveillance for identifying patients at risk for graft failure remains challenging. The fat attenuation index (FAI) of the perivascular adipose tissue in coronary computed tomography angiography (CCTA) predicts outcomes in coronary artery disease in non-transplanted hearts; however, it has not been evaluated in cardiac transplant patients. Methods We followed 39 cardiac transplant patients with two or more CCTAs obtained between 2010 and 2021. We performed FAI measurements around the proximal 4 cm segments of the left anterior descending (LAD), right coronary artery (RCA), and left circumflex artery (LCx) using a previously validated methodology. The FAI was analyzed at a threshold of − 30 to − 190 Hounsfield units. Results FAI measurements were completed in 113 CCTAs, obtained on two same-vendor CT models. Within each CCTA, the FAI values between coronary vessels were strongly correlated (RCA and LAD R = 0.67 (p < 0.0001), RCA and LCx R = 0.58 (p < 0.0001), LAD and LCx R = 0.67 (p < 0.0001)). The FAIs of each coronary vessel between the patient’s first and last CCTA completed at 120 kV were also correlated (RCA R = 0.73 (p < 0.0001), LAD R = 0.81 (p < 0.0001), LCx R = 0.55 (p = 0.0069). Finally, a high mean FAI value of all three coronary vessels at baseline (mean ≥ − 71 HU) was predictive of cardiac mortality or re-transplantation, however, not predictive of all cause-mortality. Conclusion High baseline FAI values may identify a higher-risk cardiac transplant population; thus, FAI may support the implementation of CCTA in post-transplant surveillance. Key Point • Perivascular fat attenuation measured with coronary CT is feasible in cardiac transplant patients and may predict cardiac mortality or need for re-transplantation.

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“…Moreover, user interaction is facilitated at each stage to ensure accurate and reliable results, thereby mitigating the risk of obtaining flawed measurements. By incorporating machine learning and user-friendly features, Siemens’ software solution provides an enhanced and efficient approach to FAI quantification in medical imaging [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

The Association of Coronary Fat Attenuation Index Quantified by Automated Software on Coronary Computed Tomography Angiography with Adverse Events in Patients with Less than Moderate Coronary Artery Stenosis

Zhang

Li²,

Chen

et al. 2023

Diagnostics

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Objective: This study analyzed the relationship between the coronary FAI on CCTA and coronary adverse events in patients with moderate coronary artery disease based on machine learning. Methods: A total of 172 patients with coronary artery disease with moderate or lower coronary artery stenosis were included. According to whether the patients had coronary adverse events, the patients were divided into an adverse group and a non-adverse group. The coronary FAI of patients was quantified via machine learning, and significant differences between the two groups were analyzed via t-test. Results: The age difference between the two groups was statistically significant (p < 0.001). The group that had adverse reactions was older, and there was no statistically significant difference between the two groups in terms of sex and smoking status. There was no statistical significance in the blood biochemical indexes between the two groups (p > 0.05). There was a significant difference in the FAIs between the two groups (p < 0.05), with the FAI of the defective group being greater than that of the nonperforming group. Taking the age of patients as a covariate, an analysis of covariance showed that after excluding the influence of age, the FAIs between the two groups were still significantly different (p < 0.001).

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Coronary Plaque Analysis for CT Angiography Clinical Research

Cited by 4 publications

References 13 publications

First in-human quantitative plaque characterization with ultra-high resolution coronary photon-counting CT angiography

First in-human quantitative plaque characterization with ultra-high resolution coronary photon-counting CT angiography

Evaluation of perivascular fat attenuation with coronary CT angiography in cardiac transplantation patients: an imaging biomarker candidate for prediction of cardiac mortality and re-transplantation

The Association of Coronary Fat Attenuation Index Quantified by Automated Software on Coronary Computed Tomography Angiography with Adverse Events in Patients with Less than Moderate Coronary Artery Stenosis

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