Abstract
Background and aims: Recent advancements in coronary computed tomography angiography (CCTA) have allowed for the quantitative measurement of high-risk lipid rich plaque. Determination of the optimal threshold for Hounsfield units (HU) by CCTA for identifying lipid rich plaque remains unknown. We aimed to validate reliable cut-points of HU for quantitative assessment of lipid rich plaque. Methods: 8 post-mortem sudden coronary death hearts were evaluated with CCTA and histologic analysis. Quantitative plaque analysis was performed in histopathology images and lipid rich plaque area was defined as intra-plaque necrotic core area. CCTA images were analyzed for quantitative plaque measurement. Low attenuation plaque (LAP) was defined as any pixel < 30, 45, 60, 75, and 90 HU cut-offs within a coronary plaque. The area of LAP was calculated in each cross-section. Results: Among 105 cross-sections, 37 (35.2%) cross-sectional histology images contained lipid rich plaque. Although the highest specificity for identifying lipid rich plaque was shown with <30 HU cut-off (88.2%), sensitivity (e.g. 55.6% for <75 HU, 16.2% for <30 HU) and negative predictive value (e.g. 75.9% for <75 HU, 65.9% for <30 HU) tended to increase with higher HU cut-offs. For quantitative measurement, <75 HU showed the highest correlation coefficient (0.292, p = 0.003) and no significant differences were observed between lipid rich plaque area and LAP area between histology and CT analysis (Histology: 0.34 ± 0.73 mm 2 , QCT: 0.37 ± 0.71 mm 2 , p = 0.701). Conclusions: LAP area by CCTA using a <75 HU cut-off value demonstrated high sensitivity and quantitative agreement with lipid rich plaque area by histology analysis.
| Original language | English |
|---|---|
| Pages (from-to) | 426-433 |
| Number of pages | 8 |
| Journal | Atherosclerosis |
| Volume | 275 |
| DOIs | |
| Publication status | Published - 2018 Aug |
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All Science Journal Classification (ASJC) codes
- Cardiology and Cardiovascular Medicine
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Quantitative measurement of lipid rich plaque by coronary computed tomography angiography : A correlation of histology in sudden cardiac death. / Han, Donghee; Torii, Sho; Yahagi, Kazuyuki; Lin, Fay Y.; Lee, Ji Hyun; Rizvi, Asim; Gransar, Heidi; Park, Mahn Won; Roudsari, Hadi Mirhedayati; Stuijfzand, Wijnand J.; Baskaran, Lohendran; ó Hartaigh, Bríain; Park, Hyung bok; Lee, Sang eun; Ali, Zabiullah; Kutys, Robert; Chang, Hyuk Jae; Earls, James P.; Fowler, David; Virmani, Renu; Min, James K.
In: Atherosclerosis, Vol. 275, 08.2018, p. 426-433.Research output: Contribution to journal › Article
TY - JOUR
T1 - Quantitative measurement of lipid rich plaque by coronary computed tomography angiography
T2 - A correlation of histology in sudden cardiac death
AU - Han, Donghee
AU - Torii, Sho
AU - Yahagi, Kazuyuki
AU - Lin, Fay Y.
AU - Lee, Ji Hyun
AU - Rizvi, Asim
AU - Gransar, Heidi
AU - Park, Mahn Won
AU - Roudsari, Hadi Mirhedayati
AU - Stuijfzand, Wijnand J.
AU - Baskaran, Lohendran
AU - ó Hartaigh, Bríain
AU - Park, Hyung bok
AU - Lee, Sang eun
AU - Ali, Zabiullah
AU - Kutys, Robert
AU - Chang, Hyuk Jae
AU - Earls, James P.
AU - Fowler, David
AU - Virmani, Renu
AU - Min, James K.
PY - 2018/8
Y1 - 2018/8
N2 - Background and aims: Recent advancements in coronary computed tomography angiography (CCTA) have allowed for the quantitative measurement of high-risk lipid rich plaque. Determination of the optimal threshold for Hounsfield units (HU) by CCTA for identifying lipid rich plaque remains unknown. We aimed to validate reliable cut-points of HU for quantitative assessment of lipid rich plaque. Methods: 8 post-mortem sudden coronary death hearts were evaluated with CCTA and histologic analysis. Quantitative plaque analysis was performed in histopathology images and lipid rich plaque area was defined as intra-plaque necrotic core area. CCTA images were analyzed for quantitative plaque measurement. Low attenuation plaque (LAP) was defined as any pixel < 30, 45, 60, 75, and 90 HU cut-offs within a coronary plaque. The area of LAP was calculated in each cross-section. Results: Among 105 cross-sections, 37 (35.2%) cross-sectional histology images contained lipid rich plaque. Although the highest specificity for identifying lipid rich plaque was shown with <30 HU cut-off (88.2%), sensitivity (e.g. 55.6% for <75 HU, 16.2% for <30 HU) and negative predictive value (e.g. 75.9% for <75 HU, 65.9% for <30 HU) tended to increase with higher HU cut-offs. For quantitative measurement, <75 HU showed the highest correlation coefficient (0.292, p = 0.003) and no significant differences were observed between lipid rich plaque area and LAP area between histology and CT analysis (Histology: 0.34 ± 0.73 mm 2 , QCT: 0.37 ± 0.71 mm 2 , p = 0.701). Conclusions: LAP area by CCTA using a <75 HU cut-off value demonstrated high sensitivity and quantitative agreement with lipid rich plaque area by histology analysis.
AB - Background and aims: Recent advancements in coronary computed tomography angiography (CCTA) have allowed for the quantitative measurement of high-risk lipid rich plaque. Determination of the optimal threshold for Hounsfield units (HU) by CCTA for identifying lipid rich plaque remains unknown. We aimed to validate reliable cut-points of HU for quantitative assessment of lipid rich plaque. Methods: 8 post-mortem sudden coronary death hearts were evaluated with CCTA and histologic analysis. Quantitative plaque analysis was performed in histopathology images and lipid rich plaque area was defined as intra-plaque necrotic core area. CCTA images were analyzed for quantitative plaque measurement. Low attenuation plaque (LAP) was defined as any pixel < 30, 45, 60, 75, and 90 HU cut-offs within a coronary plaque. The area of LAP was calculated in each cross-section. Results: Among 105 cross-sections, 37 (35.2%) cross-sectional histology images contained lipid rich plaque. Although the highest specificity for identifying lipid rich plaque was shown with <30 HU cut-off (88.2%), sensitivity (e.g. 55.6% for <75 HU, 16.2% for <30 HU) and negative predictive value (e.g. 75.9% for <75 HU, 65.9% for <30 HU) tended to increase with higher HU cut-offs. For quantitative measurement, <75 HU showed the highest correlation coefficient (0.292, p = 0.003) and no significant differences were observed between lipid rich plaque area and LAP area between histology and CT analysis (Histology: 0.34 ± 0.73 mm 2 , QCT: 0.37 ± 0.71 mm 2 , p = 0.701). Conclusions: LAP area by CCTA using a <75 HU cut-off value demonstrated high sensitivity and quantitative agreement with lipid rich plaque area by histology analysis.
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U2 - 10.1016/j.atherosclerosis.2018.05.024
DO - 10.1016/j.atherosclerosis.2018.05.024
M3 - Article
C2 - 29857958
AN - SCOPUS:85047598555
VL - 275
SP - 426
EP - 433
JO - Atherosclerosis
JF - Atherosclerosis
SN - 0021-9150
ER -