| Reproducibility, accuracy, and predictors of accuracy for the detection of coronary atherosclerotic plaque composition by computed tomography: an ex vivo comparison to intravascular ultrasound. | |
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MedLine Citation:
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PMID: 20479650 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To determine the reproducibility, accuracy, and predictors of accuracy of computed tomography (CT) angiography to detect and characterize coronary atherosclerotic plaque as compared with intravascular ultrasound. METHODS: Ten ex vivo human coronary arteries were imaged in a moving phantom by dual-source CT (collimation: 0.6 mm, reconstructed slice thickness: 0.4 mm) and intravascular ultrasound (IVUS). Coregistered cross-sections were assessed at 0.4 mm intervals for the presence and composition of atherosclerotic plaque (noncalcified, mixed, and calcified) on CT and IVUS by independent readers to determine reader agreement and diagnostic accuracy. Quantitative measurements of lumen and plaque area, plaque eccentricity, and intimal thickness on IVUS were used to determine predictors for the detection of noncalcified plaque by CT. RESULTS: Within 1002 coregistered cross-sections, the interobserver agreement to detect plaque on CT was K = 0.48, K = 0.42, and K = 1.00 for noncalcified, mixed, and calcified plaque; respectively. The sensitivity and specificity of CT was 57% out of 84% for noncalcified, 32% of 92% for mixed, and 56% of 93% for calcified plaque when compared with IVUS; respectively. Misclassification occurred in 68% of mixed and 43% of noncalcified plaques. The odds of detecting noncalcified plaque in CT independently increased by 56% (95% CI: 47%-77%, P < 0.0001) with every 0.1 mm increase in maximum intimal thickness as measured by IVUS. Detection rate for noncalcified plaques was poor for plaques <1 mm (36%) but excellent for plaques >1 mm maximal intimal thickness (90%). CONCLUSION: 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. |
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Authors:
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Alina G van der Giessen; Michael H Toepker; Patrick M Donelly; Fabian Bamberg; Christopher L Schlett; Christopher Raffle; Thomas Irlbeck; Hang Lee; Theo van Walsum; Pal Maurovich-Horvat; Frank J H Gijsen; Jolanda J Wentzel; Udo Hoffmann |
Publication Detail:
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Type: Comparative Study; Journal Article; Validation Studies |
Journal Detail:
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Title: Investigative radiology Volume: 45 ISSN: 1536-0210 ISO Abbreviation: Invest Radiol Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-10-05 Completed Date: 2011-06-02 Revised Date: 2011-11-09 |
Medline Journal Info:
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Nlm Unique ID: 0045377 Medline TA: Invest Radiol Country: United States |
Other Details:
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Languages: eng Pagination: 693-701 Citation Subset: IM |
Affiliation:
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Cardiac MRI PET CT Program, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02144, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Area Under Curve Confidence Intervals Coronary Artery Disease / diagnosis*, pathology, ultrasonography Coronary Vessels / pathology*, ultrasonography Female Humans Male Middle Aged Multivariate Analysis Odds Ratio Predictive Value of Tests ROC Curve Reproducibility of Results Sensitivity and Specificity Tomography, X-Ray Computed / instrumentation*, methods Ultrasonography, Interventional / instrumentation* |
| Grant Support | |
ID/Acronym/Agency:
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J 2803-B11//Austrian Science Fund FWF |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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