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Clinical application of effective atomic number for classifying non-calcified coronary plaques by dual-energy computed tomography.
- Source :
-
Atherosclerosis [Atherosclerosis] 2017 Jun; Vol. 261, pp. 138-143. Date of Electronic Publication: 2017 Mar 21. - Publication Year :
- 2017
-
Abstract
- Background and Aims: Coronary computed tomography (CT) angiography allows non-invasive classification of non-calcified coronary plaques (NCCPs) based on Hounsfield unit (HU) values. This methodology, however, is somewhat limited for reliable classification of NCCPs. Therefore, we evaluated the effective atomic number (EAN) for classifying NCCPs by single-source dual-energy CT with fast tube voltage switching (SSDECT).<br />Methods: We prospectively enrolled 18 patients undergoing both SSDECT and intravascular ultrasonography (IVUS). Monochromatic images at 70 keV and EAN images were reconstructed from SSDECT data sets. Regions of interest (ROIs) within NCCPs were placed on IVUS-matched SSDECT images, and mean HU values and EANs for soft and fibrous plaques, classified using IVUS, were compared with an unpaired t-test.<br />Results: We placed 96 ROIs in 29 soft plaques and 37 ROIs in 15 fibrous plaques in 12 coronary arteries of 11 patients. The mean HU value in soft plaques (58.2 ± 32.8 HU) was significantly lower than that in fibrous plaques (103.9 ± 48.3 HU) (p < 0.001). The mean EAN in soft plaques (8.7 ± 0.5) was also significantly lower than that in fibrous plaques (9.6 ± 0.5) (p < 0.0001). Area under the curve for EAN (0.91) was significantly higher than that for HU value (0.79) in receiver operating characteristic curve analysis (p = 0.046). With a cutoff EAN of 9.3, sensitivity was 90% and specificity, 87%; whereas with a cutoff HU value of 55.0 HU, sensitivity was 62% and specificity, 93%.<br />Conclusions: EAN measurement by SSDECT can be clinically useful for accurately classifying soft and fibrous coronary plaques.<br /> (Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.)
- Subjects :
- Adult
Aged
Area Under Curve
Coronary Artery Disease classification
Coronary Artery Disease pathology
Coronary Vessels pathology
Female
Fibrosis
Humans
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
ROC Curve
Radiation Dosage
Radiation Exposure
Reproducibility of Results
Severity of Illness Index
Ultrasonography, Interventional
Computed Tomography Angiography methods
Coronary Angiography methods
Coronary Artery Disease diagnostic imaging
Coronary Vessels diagnostic imaging
Plaque, Atherosclerotic
Radiographic Image Interpretation, Computer-Assisted methods
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1484
- Volume :
- 261
- Database :
- MEDLINE
- Journal :
- Atherosclerosis
- Publication Type :
- Academic Journal
- Accession number :
- 28372786
- Full Text :
- https://doi.org/10.1016/j.atherosclerosis.2017.03.025