AHA classification of coronary and carotid atherosclerotic plaques by grating-based phase-contrast computed tomography | springermedizin.de

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European Radiology

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17.12.2015 | Cardiac

AHA classification of coronary and carotid atherosclerotic plaques by grating-based phase-contrast computed tomography

verfasst von: Holger Hetterich, Nicole Webber, Marian Willner, Julia Herzen, Lorenz Birnbacher, Alexander Hipp, Mathias Marschner, Sigrid D. Auweter, Christopher Habbel, Ulrich Schüller, Fabian Bamberg, Birgit Ertl-Wagner, Franz Pfeiffer, Tobias Saam

Erschienen in: European Radiology | Ausgabe 9/2016

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Abstract

Objectives

To evaluate the potential of grating-based phase-contrast computed-tomography (gb-PCCT) to classify human carotid and coronary atherosclerotic plaques according to modified American Heart Association (AHA) criteria.

Methods

Experiments were carried out at a laboratory-based set-up consisting of X-ray tube (40 kVp), grating-interferometer and detector. Eighteen human carotid and coronary artery specimens were examined. Histopathology served as the standard of reference. Vessel cross-sections were classified as AHA lesion type I/II, III, IV/V, VI, VII or VIII plaques by two independent reviewers blinded to histopathology. Conservative measurements of diagnostic accuracies for the detection and differentiation of plaque types were evaluated.

Results

A total of 127 corresponding gb-PCCT/histopathology sections were analyzed. Based on histopathology, lesion type I/II was present in 12 (9.5 %), III in 18 (14.2 %), IV/V in 38 (29.9 %), VI in 16 (12.6 %), VII in 34 (26.8 %) and VIII in 9 (7.0 %) cross-sections. Sensitivity, specificity and positive and negative predictive value were ≥0.88 for most analyzed plaque types with a good level of agreement (Cohen’s kappa = 0.90). Overall, results were better in carotid (kappa = 0.97) than in coronary arteries (kappa = 0.85). Inter-observer agreement was high with kappa = 0.85, p < 0.0001.

Conclusions

These results indicate that gb-PCCT can reliably classify atherosclerotic plaques according to modified AHA criteria with excellent agreement to histopathology.

Key Points

• Different atherosclerotic plaque types display distinct morphological features in phase-contrast CT.

• Phase-contrast CT can detect and differentiate AHA plaque types.

• Calcifications caused streak artefacts and reduced sensitivity in type VI lesions.

• Overall agreement was higher in carotid than in coronary arteries.

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Titel: AHA classification of coronary and carotid atherosclerotic plaques by grating-based phase-contrast computed tomography
verfasst von: Holger Hetterich
Nicole Webber
Marian Willner
Julia Herzen
Lorenz Birnbacher
Alexander Hipp
Mathias Marschner
Sigrid D. Auweter
Christopher Habbel
Ulrich Schüller
Fabian Bamberg
Birgit Ertl-Wagner
Franz Pfeiffer
Tobias Saam
Publikationsdatum: 17.12.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 9/2016
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-4143-z

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