Diagnostic Accuracy of 320-Row Computed Tomography for Characterizing Coronary Atherosclerotic Plaques: Comparison with Intravascular Optical Coherence Tomography

Author(s)

Ybarra, Luiz F. ^{[1, 2]} ; Szarf, Gilberto ^[1] ; Ishikawa, Walther ^[1] ; Chamie, Daniel ^{[3, 4]} ; Caixeta, Adriano ^[1] ; Puri, Rishi ^[5] ; Perin, Marco A. ^[1]

Affiliation

^[1] Hosp Israelita Albert Einstein, Dept Intervent Cardiol, Sao Paulo, SP - Brazil

^[2] Western Univ, Schulich Sch Med & Dent, London Hlth Sci Ctr, 339 Windermere Rd, London, ON N6A 5A5 - Canada

^[3] Dante Pazzanese Inst Cardiol, Dept Intervent Cardiol, Sao Paulo - Brazil

^[4] Cardiovasc Res Ctr, Sao Paulo, SP - Brazil

^[5] Cleveland Clin, Dept Cardiovasc Med, Cleveland, OH 44106 - USA

• Document type: Journal article
• Source: CARDIOVASCULAR REVASCULARIZATION MEDICINE; v. 21, n. 5, p. 640-646, MAY 2020.
• Web of Science Citations: 0

Abstract

Background/purpose: This study sought to determine the diagnostic accuracy of 320-row computed tomography (320CT) for characterizing coronary atherosclerotic plaques in comparison with optical coherence tomography (OCT). Methods/materials: From 32 patients, 42 coronary segments were evaluated and co-registered by both 320CT and OCT. 320CT vulnerable plaque characteristics included low attenuation plaque (LAP) (<30HU), napkin-ring sign (NRS), positive remodeling (PR) and spotty calcification (SC). The presence of macrophage, neovascularization and cholesterol crystals was also determined by OCT. Results: Minimal lumen area was 2.78 +/- 1.23 mm by OCT and 3.29 +/- 1.49 mm by 320CT (p < 0.001). Noncalcified plaques were classified accordingly by both methods in 88.2% of the cases (p = 0.005). There was no association between any 320CT plaque type and OCT fibroatheroma (p = 0.62). The combination of 2 or more of the 320CT vulnerable plaque characteristics was associated with the presence of macrophage (74.2 vs. 25.8%; p = 0.034) and cholesterol crystals (85.7 vs. 14.3%; p = 0.04), but not with neovascularization (p = 0.65). The presence of all four characteristics demonstrated an accuracy of 75.1% for detecting OCT fibroatheroma. Conclusions: 320CT is useful for non-invasive evaluation of calcified and noncalcified tissue characteristics of coronary atheroma. The combination of all four 320CT vulnerable plaque characteristics provided the highest accuracy for detecting fibroatheromas. ITALIC]Summary: 320CT is useful for non-invasive evaluation of calcified and noncalcified tissue characteristics of coronary atheroma. The combination of all 320CT vulnerable plaque characteristics (low attenuation plaque (<30HU), napkin-ring sign, positive remodeling and spotty calcification) provided the highest accuracy for detecting fibroatheromas compared to optical coherence tomography. (C) 2019 Elsevier Inc. All rights reserved. (AU)

• FAPESP's process: 15/02239-6 - Coronary atherosclerosis evaluation by intracoronary optical coherence tomography and 320-row coronary computed tomography: correlation and concordance of the findings of both methods
• Grantee: Luiz Fernando Ybarra Martins de Oliveira
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)
• FAPESP's process: 15/00485-0 - Coronary atherosclerosis evaluation by intracoronary optical coherence tomography and 320-row coronary computed tomography: correlation and concordance of the findings of both methods
• Grantee: Marco Antonio Perin
• Support Opportunities: Regular Research Grants