Iterative image reconstruction algorithms in coronary CT angiography improve the detection of lipid-core plaque – a comparison with histology

Objectives To evaluate whether iterative reconstruction algorithms improve the diagnostic accuracy of coronary CT angiography (CCTA) for detection of lipid-core plaque (LCP) compared to histology. Methods and materials CCTA and histological data were acquired from three ex vivo hearts. CCTA images w...

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Veröffentlicht in:European radiology Jg. 25; H. 1; S. 15 - 23
Hauptverfasser: Puchner, Stefan B., Ferencik, Maros, Maurovich-Horvat, Pal, Nakano, Masataka, Otsuka, Fumiyuki, Kauczor, Hans-Ulrich, Virmani, Renu, Hoffmann, Udo, Schlett, Christopher L.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Berlin/Heidelberg Springer Berlin Heidelberg 01.01.2015
Springer Nature B.V
Schlagworte:
Accuracy
Adult
Aged
Algorithms
Atherosclerosis
Breast
Cardiovascular disease
Coronary Angiography - methods
Coronary Artery Disease - diagnosis
Coronary vessels
Coronary Vessels - pathology
Diagnostic Radiology
Electric noise
Histology
Hospitals
Humans
Imaging
Internal Medicine
Interventional Radiology
Lipids
Medical imaging
Medicine
Medicine & Public Health
Middle Aged
Neuroradiology
Plaque, Atherosclerotic - diagnosis
Radiographic Image Enhancement - methods
Radiographic Image Interpretation, Computer-Assisted - methods
Radiology
Reproducibility of Results
Tomography
Tomography, X-Ray Computed - methods
Ultrasound
Vein & artery diseases
United States > US
Massachusetts
Low attenuation plaque
Vulnerable plaque
Coronary CT angiography
Iterative reconstruction algorithm
Diagnostic accuracy
ISSN:0938-7994, 1432-1084, 1432-1084
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Zusammenfassung:Objectives To evaluate whether iterative reconstruction algorithms improve the diagnostic accuracy of coronary CT angiography (CCTA) for detection of lipid-core plaque (LCP) compared to histology. Methods and materials CCTA and histological data were acquired from three ex vivo hearts. CCTA images were reconstructed using filtered back projection (FBP), adaptive-statistical (ASIR) and model-based (MBIR) iterative algorithms. Vessel cross-sections were co-registered between FBP/ASIR/MBIR and histology. Plaque area <60 HU was semiautomatically quantified in CCTA. LCP was defined by histology as fibroatheroma with a large lipid/necrotic core. Area under the curve (AUC) was derived from logistic regression analysis as a measure of diagnostic accuracy. Results Overall, 173 CCTA triplets (FBP/ASIR/MBIR) were co-registered with histology. LCP was present in 26 cross-sections. Average measured plaque area <60 HU was significantly larger in LCP compared to non-LCP cross-sections (mm 2 : 5.78 ± 2.29 vs. 3.39 ± 1.68 FBP; 5.92 ± 1.87 vs. 3.43 ± 1.62 ASIR; 6.40 ± 1.55 vs. 3.49 ± 1.50 MBIR; all p  < 0.0001). AUC for detecting LCP was 0.803/0.850/0.903 for FBP/ASIR/MBIR and was significantly higher for MBIR compared to FBP ( p  = 0.01). MBIR increased sensitivity for detection of LCP by CCTA. Conclusion Plaque area <60 HU in CCTA was associated with LCP in histology regardless of the reconstruction algorithm. However, MBIR demonstrated higher accuracy for detecting LCP, which may improve vulnerable plaque detection by CCTA. Key Points • A low attenuation plaque area is associated with the presence of lipid - core plaque • MBIR leads to higher diagnostic accuracy for detecting lipid - core plaque • The benefit of MBIR is mainly due to increased sensitivity at high specificities • Semiautomated CCTA assessment can detect vulnerable plaques non - invasively
Bibliographie:SourceType-Scholarly Journals-1
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ISSN:0938-7994
1432-1084
1432-1084
DOI:10.1007/s00330-014-3404-6