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...

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Publicado en:European Radiology Vol. 25; no. 1; pp. 15 - 24
Autores principales: Puchner, Stefan B, Ferencik, Maros, Maurovich-Horvat, Pal, Nakano, Masataka, Otsuka, Fumiyuki, Kauczor, Hans-Ulrich, Virmani, Renu, Hoffmann, Udo, Schlett, Christopher L
Formato: research Journal Article
Publicado: Springer Nature Jan2015
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jan2015
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00330-014-3404-6
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        atl: Iterative image reconstruction algorithms in coronary CT angiography improve the detection of lipid-core plaque--a comparison with histology.
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        au:
          Puchner, Stefan B
          Ferencik, Maros
          Maurovich-Horvat, Pal
          Nakano, Masataka
          Otsuka, Fumiyuki
          Kauczor, Hans-Ulrich
          Virmani, Renu
          Hoffmann, Udo
          Schlett, Christopher L
        affil: Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
      sug:
        subj:
          Coronary Angiography Methods
          Coronary Arteriosclerosis Diagnosis
          Coronary Vessels Pathology
          Atherosclerosis Diagnosis
          Radiographic Image Enhancement Methods
          Radiographic Image Interpretation, Computer-Assisted Methods
          Tomography, X-Ray Computed Methods
          Adult
          Aged
          Algorithms
          Human
          Lipids
          Middle Age
          Reproducibility of Results
          Adult: 19-44 years
          Aged: 65+ years
          Middle Aged: 45-64 years
      ab: 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.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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