Abstract 16439: Accuracy of Automated Coronary Atherosclerotic Plaque Quantification Algorithm on Coronary Computed Tomography Angiography: Comparison With Intravascular Ultrasound
Background: Coronary computed tomographic angiography (cCTA) has emerged as a promising non-invasive modality not only to detect coronary artery stenosis, but to assess atherosclerotic plaque surrounding lumen. Although future prognosis and lesion specific ischemia is more closely related with plaque volume or plaque burden, to date, accurate method of 3D plaque quantification is not feasible. Therefore, we explored whether novel automated 3D coronary plaque quantification algorithm (QCT) correlate with plaque quantification by invasive intravascular ultrasound (IVUS).
Method: Thirty patients with suspicious coronary artery disease (CAD) underwent cCTA and invasive coronary angiography (ICA) with IVUS. Overall, 30 coronary artery segments from 30 patients which pertained culprit lesion confirmed by ICA and IVUS were analyzed. Culprit segment was defined as between bifurcations proximal and distal to culprit lesion. cCTA and IVUS images were analyzed blindly by cCTA and IVUS core-laboratories, respectively. Vessel volume, lumen volume, plaque volume, and plaque burden were measured. Plaque burden defined as an average cross sectional plaque area divided by average vessel area.
Result: Among 30 segments 17 segments (57%) were left anterior descending artery, 5 segments (17%) were left circumflex artery, 7 segments (23%) were right coronary artery. Plaque types were characterized as mixed (60%), non-calcified (30%) and calcified (10%). The correlation coefficient of plaque volume between cCTA and IVUS was high (r = 0.92, p = 0.0019) with corresponding bias and 95% limits of agreement of 11.9mm3 (-45.9 to 69.6). The correlation coefficient of vessel volume, lumen volume and plaque burden were 0.95 (95% CI 0.89-0.97, p<0.001), 0.82 (95% CI 0.65-0.91, p<0.001), and 0.79 (95% CI 0.61-0.91, p<0.001), respectively.
Conclusion: We confirmed that novel 3D automated method of coronary artery plaque quantification showed excellent correlation with plaque quantification by invasive IVUS. This technique may be used as an efficient tool for comprehensive analysis of CAD in a non-invasive manner.
- © 2013 by American Heart Association, Inc.