Document Detail


Reproducibility, accuracy, and predictors of accuracy for the detection of coronary atherosclerotic plaque composition by computed tomography: an ex vivo comparison to intravascular ultrasound.
MedLine Citation:
PMID:  20479650     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Comparative Study; Journal Article; Validation Studies    
Journal Detail:
Title:  Investigative radiology     Volume:  45     ISSN:  1536-0210     ISO Abbreviation:  Invest Radiol     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-05     Completed Date:  2011-06-02     Revised Date:  2011-11-09    
Medline Journal Info:
Nlm Unique ID:  0045377     Medline TA:  Invest Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  693-701     Citation Subset:  IM    
Affiliation:
Cardiac MRI PET CT Program, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02144, USA.
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MeSH Terms
Descriptor/Qualifier:
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:
J 2803-B11//Austrian Science Fund FWF

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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