Reproducibility, Accuracy, and Predictors of Accuracy for the Detection of Coronary Atherosclerotic Plaque Composition by Computed Tomography

Abstract

Reader agreement and diagnostic accuracy for the detection of coronary atherosclerotic plaque vary with plaque composition. Intimal thickness independently predicts detection of noncalcified plaque by CT with excellent sensitivity for >1 mm thick plaques.

Photon counting spectral CT component analysis of coronary artery atherosclerotic plaque samples

“…Secondly, CT is limited in correctly identifying plaque components, especially for the detection of the lipid core out of the normal wall or the fibrous plaque components. [4][5][6][7][8] These problems are related to the insufficient spatial resolution available with the current clinical system and to the overlaps of the Hounsfield values between iodine and calcifications on one hand and the lipid core and other soft components of the arterial wall on the other hand. Improved differentiation between calcification and iodine was obtained with energy CT. 8,9 Furthermore, photon counting spectral CT has recently been proposed to improve tissue characterization by improving the measurement of the energy dependence of the attenuation of various tissues in comparison with conventional CT scanners.…”

Interobserver agreement for the detection of atherosclerotic plaque in coronary CT angiography: comparison of two low-dose image acquisition protocols with standard retrospectively ECG-gated reconstruction

“…We neither quantified plaque volumes nor measured plaque densities or determined other highrisk features such as coronary remodelling. Our measurements were not compared with an independent gold standard such as intravascular ultrasound [38][39][40][41]. Interobserver agreement was not evaluated according to an image quality scale.…”

Imaging of atherosclerosis

“…57 The sensitivity of CCTA to detect noncalcific plaques with >1 mm intimal thickness on IVUS is roughly 90%. 58 When compared with VH-IVUS, fibrous plaques display high attenuation on CT, whereas low attenuation occurs in relation to necrotic core and fibrofatty tissue. 59 Good correlations have also been shown between high-risk CT features and TCFA on OCT, 60 and CT-derived plaque burden to cholesterol deposition on NIRS.…”