https://orcid.org/0000-0003-1443-5788
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Edoardo Conte, Saima Mushtaq, Gianluca Pontone, Letizia Li Piani, Paolo Ravagnani, Stefano Galli, Carlos Collet, Jeroen Sonck, Luca Di Odoardo, Marco Guglielmo, Andrea Baggiano, Daniela Trabattoni, Andrea Annoni, Maria Elisabetta Mancini, Alberto Formenti, Giuseppe Muscogiuri, Marco Magatelli, Flavia Nicoli, Carlotta Poggi, Cesare Fiorentini, Antonio L Bartorelli, Mauro Pepi, Piero Montorsi, Daniele Andreini, Plaque quantification by coronary computed tomography angiography using intravascular ultrasound as a reference standard: a comparison between standard and last generation computed tomography scanners, European Heart Journal - Cardiovascular Imaging, Volume 21, Issue 2, February 2020, Pages 191–201, https://doi.org/10.1093/ehjci/jez089
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Abstract
The emerging role of coronary computed tomography angiography (CCTA) as a non-invasive tool for atherosclerosis evaluation is supported by data reporting a good correlation between CCTA and intravascular ultrasound (IVUS) for plaque volume quantification. Aim of the present study was to evaluate whether a last generation CT-scanner may improve coronary plaque volume assessment using IVUS as standard-of-reference.
From a registry of 1915 consecutive, all-comers, patients who underwent a clinically indicated IVUS evaluation we enrolled 59 patients who underwent CCTA with a 64-slice CT (Group 1) and 59 patients who underwent CCTA with whole-heart coverage CT scanner (Group 2). Patients who underwent CCTA with unfavourable heart rhythm were not excluded from the analysis. Image quality (4-point Likert scale) focused on plaque analysis was evaluated. Plaque volume quantification by CCTA was compared to IVUS. No difference in clinical characteristics was found between Group 1 and Group 2. Plaque volume quantification by CCTA was considered not feasible in 11 plaques of Group 1 and in 4 plaques of Group 2 (P = 0.09). Higher correlation for plaque volume quantification by CCTA vs. IVUS was demonstrated in Group 2 when compared with Group 1 (r = 0.9888 vs. 0.9499; P < 0.0001). The Bland–Altman analysis showed plaque volume overestimation by CCTA of 11.9 mm3 in Group 1 and 4 mm2 in Group 2 (P < 0.001). Effective radiation dose of CCTA was significantly lower in Group 2 vs. Group 1 (2.7 ± 0.9 vs. 8.1 ± 3.6 mSv, respectively; P < 0.001).
CCTA using a new scanner generation showed to be an accurate non-invasive tool to assess and quantify coronary plaque volume.
