Ran Heo1,2, Hyung-Bok Park1,3, Byoung Kwon Lee4, Sanghoon Shin1,5, Reza Arsanjani6, James K Min7, Hyuk-Jae Chang8,9. 1. Yonsei-Cedars Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University Health System, Seoul, South Korea. 2. Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea. 3. Division of Cardiology, Cardiovascular Center, Myongji Hospital, Seonam University College of Medicine, Goyang, South Korea. 4. Division of Cardiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea. 5. Division of Cardiology, National Health Insurance Corporation Ilsan Hospital, Goyang, South Korea. 6. Departments of Imaging and Medicine, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA. 7. Institute for Cardiovascular Imaging, Weill-Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA. 8. Yonsei-Cedars Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University Health System, Seoul, South Korea. HJCHANG@yuhs.ac. 9. Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea. HJCHANG@yuhs.ac.
Abstract
OBJECTIVE: To evaluate optimal methodology for quantitative plaque volume analysis by coronary CT angiography (QCT). METHODS: Fifty-one coronary artery segments were evaluated and contour measurements based on two different methods [(1) no gap, or (2) fixed 0.3-mm gap between inner and outer boundary] were compared with intravascular ultrasound (IVUS). In addition, three different window width (WW) and level (WL) settings [fixed (740/220) Hounsfield unit (HU), adjusted (155 % and 65 % of mean luminal intensity of the segment, and aorta adjusted (155 % and 65 % of mean luminal intensity of central aorta)] were used for semiautomated plaque volume analysis. RESULTS: For boundary detection, the no gap method led to underestimation compared with IVUS (105.4 ± 82.3 vs. 136.1 ± 72.8 mm(3), p < 0.001), while fixed 0.3-mm gap showed no difference between IVUS and QCT (136.1 ± 72.8 vs. 139.8 ± 93.9 mm(3), p = 0.50). Comparison of the three different window settings demonstrated that the aorta adjusted setting underestimated (120.5 ± 74.3 vs. 136.1 ± 72.8 mm(3), p = 0.003), while fixed setting showed the least mean difference compared with IVUS (3.8 ± 39.8 mm(3), p = 0.50). CONCLUSION: For plaque volumetric assessment, optimal results were obtained with fixed 0.3-mm gap with fixed HU setting (740/220). KEY POINTS: • Quantitative plaque volume analysis by coronary CT angiography has recently emerged. • Different boundary detection methods and window width and level settings were evaluated. • Fixed 0.3-mm gap with fixed HU setting (740/220) afforded optimal results.
OBJECTIVE: To evaluate optimal methodology for quantitative plaque volume analysis by coronary CT angiography (QCT). METHODS: Fifty-one coronary artery segments were evaluated and contour measurements based on two different methods [(1) no gap, or (2) fixed 0.3-mm gap between inner and outer boundary] were compared with intravascular ultrasound (IVUS). In addition, three different window width (WW) and level (WL) settings [fixed (740/220) Hounsfield unit (HU), adjusted (155 % and 65 % of mean luminal intensity of the segment, and aorta adjusted (155 % and 65 % of mean luminal intensity of central aorta)] were used for semiautomated plaque volume analysis. RESULTS: For boundary detection, the no gap method led to underestimation compared with IVUS (105.4 ± 82.3 vs. 136.1 ± 72.8 mm(3), p < 0.001), while fixed 0.3-mm gap showed no difference between IVUS and QCT (136.1 ± 72.8 vs. 139.8 ± 93.9 mm(3), p = 0.50). Comparison of the three different window settings demonstrated that the aorta adjusted setting underestimated (120.5 ± 74.3 vs. 136.1 ± 72.8 mm(3), p = 0.003), while fixed setting showed the least mean difference compared with IVUS (3.8 ± 39.8 mm(3), p = 0.50). CONCLUSION: For plaque volumetric assessment, optimal results were obtained with fixed 0.3-mm gap with fixed HU setting (740/220). KEY POINTS: • Quantitative plaque volume analysis by coronary CT angiography has recently emerged. • Different boundary detection methods and window width and level settings were evaluated. • Fixed 0.3-mm gap with fixed HU setting (740/220) afforded optimal results.
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