Non-invasive assessment of plaque morphology and remodeling in mildly stenotic coronary segments: comparison of 16-slice computed tomography and intravascular ultrasound

Schoenhagen, Paul; Tuzcu, E. Murat; Stillman, Arthur E.; Moliterno, David J.; Halliburton, Sandra S.; Kuzmiak, Stacie; Kasper, J; Magyar, William A.; Lieber, Michael L.; Nissen, Steven E.; White, Richard D.

doi:10.1097/00019501-200309000-00007

Cited by 146 publications

(67 citation statements)

References 8 publications

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“…[3][4][5][6][7][8] Possible applications in risk stratification of asymptomatic individuals have been discussed 2 but require close scrutiny of the actual ability of MDCT to detect nonstenotic coronary plaque. In comparison with IVUS, we found a sensitivity of 82% to detect coronary artery segments containing atherosclerotic plaque in patients without significant coronary artery stenoses.…”

Section: Discussionmentioning

confidence: 99%

Detection of Calcified and Noncalcified Coronary Atherosclerotic Plaque by Contrast-Enhanced, Submillimeter Multidetector Spiral Computed Tomography

et al. 2004

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Background-We investigated the ability of multidetector spiral computed tomography (MDCT) to detect atherosclerotic plaque in nonstenotic coronary arteries. Methods and Results-In 22 patients without significant coronary stenoses, contrast-enhanced MDCT (0.75-mm collimation, 420-ms rotation) and intravascular ultrasound (IVUS) of one coronary artery were performed. A total of 83 coronary segments were imaged by IVUS (left main, 19; left anterior descending, 51; left circumflex, 4; right coronary, 9). MDCT data sets were evaluated for the presence and volume of plaque in the coronary artery segments. Results were compared with IVUS in a blinded fashion. For the detection of segments with any plaque, MDCT had a sensitivity of 82% (41 of 50) and specificity of 88% (29 of 33). For calcified plaque, sensitivity was 94% (33 of 36) and specificity 94% (45 of 47). Coronary segments containing noncalcified plaque were detected with a sensitivity of 78% (35 of 45) and specificity of 87% (33 of 38), but presence of exclusively noncalcified plaque was detected with only 53% sensitivity (8 of 15). If analysis was limited to the 41 proximal segments (segments 1, 5, 6, and 11 according to American Heart Association classification), sensitivity and specificity were 92% and 88% for any plaque, 95% and 91% for calcified plaque, and 91% and 89% for noncalcified plaque. MDCT substantially underestimated plaque volume per segment as compared with IVUS (24Ϯ35 mm 3 versus 43Ϯ60 mm 3 , PϽ0.001). Conclusions-The results indicate the potential of MDCT to detect coronary atherosclerotic plaque in patients without significant coronary stenoses. However, further improvements in image quality will be necessary to achieve reliable assessment, especially of noncalcified plaque throughout the coronary tree. Key Words: tomography Ⅲ atherosclerosis Ⅲ coronary disease D irect, noninvasive imaging of coronary atherosclerotic plaque might potentially improve risk stratification for the occurrence of coronary events in selected asymptomatic individuals. 1,2 Initial reports of the ability of contrastenhanced multidetector spiral computed tomography (MDCT) to visualize noncalcified coronary atherosclerotic plaque have thus received widespread attention. [3][4][5][6][7][8] However, the ability of MDCT to detect and quantify coronary atherosclerotic plaque in vivo has never been systematically validated. We therefore evaluated the ability of MDCT with submillimeter slice collimation to detect and quantify coronary atherosclerotic plaque in patients without significant coronary artery stenoses in comparison with intravascular ultrasound (IVUS). Methods PatientsIn 22 patients (14 male, 8 female; mean age, 58 years), MDCT was performed as part of research protocols that enrolled consecutive subjects who were scheduled for invasive coronary angiography for clinical reasons. In all patients, coronary artery stenoses (Ն50% diameter reduction) had been ruled out by coronary angiography, and an IVUS study of the largest coronary vessel was performed. Patients wi...

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Section: Discussionmentioning

confidence: 99%

Detection of Calcified and Noncalcified Coronary Atherosclerotic Plaque by Contrast-Enhanced, Submillimeter Multidetector Spiral Computed Tomography

et al. 2004

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“…Computed-tomography coronary angiography (CTA) allows identification and quantification of calcified and non-calcified coronary plaques [76][77][78][79] . Based on the presence or distribution of plaques (one-, two-or three-vessel disease) and stenosis severity (>50% diameter stenosis), the plaque burden of the entire coronary tree can be established 80 .…”

Section: Multidetector Computed Tomographymentioning

confidence: 99%

Métodos por imagem da aterosclerose em estudos de progressão/regressão: marcador substituto ou janela direta para o processo patológico da aterosclerose?

Schoenhagen¹,

Tuzcu²

2008

Arq. Bras. Cardiol.

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SummaryCAD remains a major global cause of morbidity and mortality. Comprehensive drug development programs of novel pharmacological treatment strategies frequently utilize traditional mortality/morbidity endpoints studies and additional surrogate endpoints trials. This parallel approach allows an assessment of efficacy several years in advance of the availability of data from clinical endpoint trials. Several atherosclerosis imaging markers have been introduced into these drug-development strategies, including angiography, carotid ultrasound, IVUS, MRI, and CT. This review will discuss the current status of atherosclerosis imaging as an endpoint in progression/regression trials, with an emphasis on evidence-based data. In addition to a discussion of the results of individual imaging modalities, the emerging data comparing different modalities and approaches are presented.

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“…In recent years, multi-slice computed tomography (MSCT) has emerged as a promising tool for non-invasive plaque characterization [14][15][16][17][18][19][20]. However, until now, its capacity to accurately quantify and characterize the non-calcified plaque has been restricted by limited temporal and spatial resolution.…”

Section: Introductionmentioning

confidence: 99%

Characterization of coronary atherosclerosis by dual-source computed tomography and HU-based color mapping: a pilot study

et al. 2008

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Non-invasive assessment of plaque morphology and remodeling in mildly stenotic coronary segments: comparison of 16-slice computed tomography and intravascular ultrasound

Abstract: State-of-the-art MSCT can accurately identify mildly stenotic coronary atherosclerosis and provide an assessment of morphology and remodeling response.

Cited by 146 publications

References 8 publications

Detection of Calcified and Noncalcified Coronary Atherosclerotic Plaque by Contrast-Enhanced, Submillimeter Multidetector Spiral Computed Tomography

Detection of Calcified and Noncalcified Coronary Atherosclerotic Plaque by Contrast-Enhanced, Submillimeter Multidetector Spiral Computed Tomography

Métodos por imagem da aterosclerose em estudos de progressão/regressão: marcador substituto ou janela direta para o processo patológico da aterosclerose?

Characterization of coronary atherosclerosis by dual-source computed tomography and HU-based color mapping: a pilot study

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