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23.08.2017 | Cardiac

Coronary CT angiography characteristics of OCT-defined thin-cap fibroatheroma: a section-to-section comparison study

verfasst von: Dong Hyun Yang, Soo-Jin Kang, Hyun Jung Koo, Mineok Chang, Joon-Won Kang, Tae-Hwan Lim, Seunghee Baek, Seungbong Han, Pil Hyung Lee, Jae-Hyung Roh, Jung-Min Ahn, Duk-Woo Park, Seung-Whan Lee, Cheol Whan Lee, Seong-Wook Park, Seung-Jung Park, Gary S. Mintz, Young-Hak Kim

Erschienen in: European Radiology | Ausgabe 2/2018

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Abstract

Objectives

To evaluate whether plaque characteristics as assessed by coronary computed tomography angiography (CCTA) were associated with the presence of a thin-cap fibroatheroma (TCFA)—a precursor of plaque rupture—defined by optical coherence tomography (OCT) in a section-to-section-level comparison.

Methods

From 28 symptomatic patients, 31 coronary lesions were evaluated on 727 cross-sections co-registered by both CCTA and OCT. CCTA plaque characteristics included low attenuation plaque (LAP, <30 HU), napkin ring sign (NRS), positive remodelling (PR, remodelling index ≥1.10), and spotty calcification and plaque area and plaque burden. By OCT, presence of TCFA, lumen area and arc of lipid were determined.

Results

OCT revealed a TCFA in 69 (9.4%) sections from 19 (61.2 %) lesions. In per-section analysis, OCT-TCFA showed higher frequency of CCTA-detected LAP (58.0% vs. 18.5%), NRS (31.9% vs. 8.8%) and PR (68.1% vs. 48.0%) and greater plaque burden (70.6% vs. 61.9%) as compared to sections without OCT-TCFA (all p < 0.05). In multivariable analysis, LAP (odds ratio [OR] 4.05, p < 0.001) and NRS (OR 2.47, p = 0.005) were associated with OCT-TCFA. CCTA-measured lumen area correlated well with OCT-measured lumen area (R = 0.859, limits of agreement −0.5 ± 3.7 mm²).

Conclusions

LAP and NRS in CCTA were associated with the presence of OCT-defined TCFA in a section-to-section comparison.

Key Points

• CT-defined LAP and NRS were associated with OCT-defined TCFA

• OCT-TCFA showed higher frequency of LAP, NRS, PR and greater plaque burden

• Non-calcified plaque area was correlated with OCT-measured lipid arc

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Puchner SB, Liu T, Mayrhofer T et al (2014) High-risk plaque detected on coronary CT angiography predicts acute coronary syndromes independent of significant stenosis in acute chest pain: results from the ROMICAT-II trial. J Am Coll Cardiol 64:684–692CrossRefPubMedPubMedCentral

Hecht HS, Achenbach S, Kondo T, Narula J (2015) High-risk plaque features on coronary CT angiography. JACC Cardiovasc Imaging 8:1336–1339CrossRefPubMed

Kristensen TS, Kofoed KF, Kuhl JT, Nielsen WB, Nielsen MB, Kelbaek H (2011) Prognostic implications of nonobstructive coronary plaques in patients with non-ST-segment elevation myocardial infarction: a multidetector computed tomography study. J Am Coll Cardiol 58:502–509CrossRefPubMed

Maurovich-Horvat P, Ferencik M, Voros S, Merkely B, Hoffmann U (2014) Comprehensive plaque assessment by coronary CT angiography. Nat Rev Cardiol 11:390–402CrossRefPubMed

Motoyama S, Kondo T, Sarai M et al (2007) Multislice computed tomographic characteristics of coronary lesions in acute coronary syndromes. J Am Coll Cardiol 50:319–326CrossRefPubMed

Motoyama S, Ito H, Sarai M et al (2015) Plaque characterization by coronary computed tomography angiography and the likelihood of acute coronary events in mid-term follow-up. J Am Coll Cardiol 66:337–346CrossRefPubMed

Versteylen MO, Kietselaer BL, Dagnelie PC et al (2013) Additive value of semiautomated quantification of coronary artery disease using cardiac computed tomographic angiography to predict future acute coronary syndrome. J Am Coll Cardiol 61:2296–2305CrossRefPubMed

Nadjiri J, Hausleiter J, Jahnichen C et al (2016) Incremental prognostic value of quantitative plaque assessment in coronary CT angiography during 5 years of follow up. J Cardiovasc Comput Tomogr 10:97–104CrossRefPubMed

Dwivedi G, Liu Y, Tewari S, Inacio J, Pelletier-Galarneau M, Chow BJ (2016) Incremental prognostic value of quantified vulnerable plaque by cardiac computed tomography: a pilot study. J Thorac Imaging 31:373–379CrossRefPubMed

10.

Burke AP, Farb A, Malcom GT, Liang YH, Smialek J, Virmani R (1997) Coronary risk factors and plaque morphology in men with coronary disease who died suddenly. N Engl J Med 336:1276–1282CrossRefPubMed

11.

Otsuka F, Joner M, Prati F, Virmani R, Narula J (2014) Clinical classification of plaque morphology in coronary disease. Nat Rev Cardiol 11:379–389CrossRefPubMed

12.

Narula J, Nakano M, Virmani R et al (2013) Histopathologic characteristics of atherosclerotic coronary disease and implications of the findings for the invasive and noninvasive detection of vulnerable plaques. J Am Coll Cardiol 61:1041–1051CrossRefPubMedPubMedCentral

13.

Fujii K, Hao H, Shibuya M et al (2015) Accuracy of OCT, grayscale IVUS, and their combination for the diagnosis of coronary TCFA: an ex vivo validation study. JACC Cardiovasc Imaging 8:451–460CrossRefPubMed

14.

Cademartiri F, Mollet NR, Runza G et al (2005) Influence of intracoronary attenuation on coronary plaque measurements using multislice computed tomography: observations in an ex vivo model of coronary computed tomography angiography. Eur Radiol 15:1426–1431CrossRefPubMed

15.

Kashiwagi M, Tanaka A, Kitabata H et al (2009) Feasibility of noninvasive assessment of thin-cap fibroatheroma by multidetector computed tomography. JACC Cardiovasc Imaging 2:1412–1419CrossRefPubMed

16.

Ito T, Terashima M, Kaneda H et al (2011) Comparison of in vivo assessment of vulnerable plaque by 64-slice multislice computed tomography versus optical coherence tomography. Am J Cardiol 107:1270–1277CrossRefPubMed

17.

Nakazato R, Otake H, Konishi A et al (2015) Atherosclerotic plaque characterization by CT angiography for identification of high-risk coronary artery lesions: a comparison to optical coherence tomography. Eur Heart J Cardiovasc Imaging 16:373–379CrossRefPubMed

18.

Nasu K, Tsuchikane E, Katoh O et al (2006) Accuracy of in vivo coronary plaque morphology assessment: a validation study of in vivo virtual histology compared with in vitro histopathology. J Am Coll Cardiol 47:2405–2412CrossRefPubMed

19.

Maurovich-Horvat P, Schlett CL, Alkadhi H et al (2012) The napkin-ring sign indicates advanced atherosclerotic lesions in coronary CT angiography. JACC Cardiovasc Imaging 5:1243–1252CrossRefPubMed

20.

Abbara S, Arbab-Zadeh A, Callister TQ et al (2009) SCCT guidelines for performance of coronary computed tomographic angiography: a report of the Society of Cardiovascular Computed Tomography Guidelines Committee. J Cardiovasc Comput Tomogr 3:190–204CrossRefPubMed

21.

Sinclair H, Bourantas C, Bagnall A, Mintz GS, Kunadian V (2015) OCT for the identification of vulnerable plaque in acute coronary syndrome. JACC Cardiovasc Imaging 8:198–209CrossRefPubMed

22.

Park HB, Heo R, o Hartaigh B et al (2015) Atherosclerotic plaque characteristics by CT angiography identify coronary lesions that cause ischemia: a direct comparison to fractional flow reserve. JACC Cardiovasc Imaging 8:1–10CrossRefPubMedPubMedCentral

23.

Genders TS, Spronk S, Stijnen T, Steyerberg EW, Lesaffre E, Hunink MG (2012) Methods for calculating sensitivity and specificity of clustered data: a tutorial. Radiology 265:910–916CrossRefPubMed

24.

Stone GW, Maehara A, Lansky AJ et al (2011) A prospective natural-history study of coronary atherosclerosis. N Engl J Med 364:226–235CrossRefPubMed

25.

Cheng JM, Garcia-Garcia HM, de Boer SP et al (2014) In vivo detection of high-risk coronary plaques by radiofrequency intravascular ultrasound and cardiovascular outcome: results of the ATHEROREMO-IVUS study. Eur Heart J 35:639–647CrossRefPubMed

26.

Calvert PA, Obaid DR, O'Sullivan M et al (2011) Association between IVUS findings and adverse outcomes in patients with coronary artery disease: the VIVA (VH-IVUS in Vulnerable Atherosclerosis) Study. JACC Cardiovasc Imaging 4:894–901CrossRefPubMed

27.

Miyamoto Y, Okura H, Kume T et al (2011) Plaque characteristics of thin-cap fibroatheroma evaluated by OCT and IVUS. JACC Cardiovasc Imaging 4:638–646CrossRefPubMed

28.

Park HB, Lee BK, Shin S et al (2015) Clinical Feasibility of 3D automated coronary atherosclerotic plaque quantification algorithm on coronary computed tomography angiography: comparison with intravascular ultrasound. Eur Radiol 25:3073–3083CrossRefPubMed

29.

Voros S, Rinehart S, Qian Z et al (2011) Coronary atherosclerosis imaging by coronary CT angiography: current status, correlation with intravascular interrogation and meta-analysis. JACC Cardiovasc Imaging 4:537–548CrossRefPubMed

30.

Leeflang MM, Rutjes AW, Reitsma JB, Hooft L, Bossuyt PM (2013) Variation of a test's sensitivity and specificity with disease prevalence. CMAJ 185:E537–E544CrossRefPubMedPubMedCentral

31.

Boogers MJ, Broersen A, van Velzen JE et al (2012) Automated quantification of coronary plaque with computed tomography: comparison with intravascular ultrasound using a dedicated registration algorithm for fusion-based quantification. Eur Heart J 33:1007–1016CrossRefPubMed

Titel: Coronary CT angiography characteristics of OCT-defined thin-cap fibroatheroma: a section-to-section comparison study
verfasst von: Dong Hyun Yang
Soo-Jin Kang
Hyun Jung Koo
Mineok Chang
Joon-Won Kang
Tae-Hwan Lim
Seunghee Baek
Seungbong Han
Pil Hyung Lee
Jae-Hyung Roh
Jung-Min Ahn
Duk-Woo Park
Seung-Whan Lee
Cheol Whan Lee
Seong-Wook Park
Seung-Jung Park
Gary S. Mintz
Young-Hak Kim
Publikationsdatum: 23.08.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 2/2018
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-017-4992-8

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Coronary CT angiography characteristics of OCT-defined thin-cap fibroatheroma: a section-to-section comparison study