Prospective deep learning-based quantitative assessment of coronary plaque by computed tomography angiography compared with intravascular ultrasound: the REVEALPLAQUE study.

Autor:	Narula J; Heart & Vascular Institute, McGovern Medical School, 1825 Pressler Street, SRB 205A, Houston, TX 77030, USA., Stuckey TD; Heart & Vascular, LeBauer-Brodie Center/Cone Health Heart and Vascular, Greensboro, NC, USA., Nakazawa G; Department of Medicine, Kindai University, Osaka, Japan., Ahmadi A; Cardiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Matsumura M; Cardiology, Cardiovascular Research Foundation, New York, NY, USA., Petersen K; HeartFlow, Inc., Mountain View, CA, USA., Mirza S; HeartFlow, Inc., Mountain View, CA, USA., Ng N; HeartFlow, Inc., Mountain View, CA, USA., Mullen S; HeartFlow, Inc., Mountain View, CA, USA., Schaap M; HeartFlow, Inc., Mountain View, CA, USA., Leipsic J; Radiology, University of British Columbia, Vancouver, Canada., Rogers C; HeartFlow, Inc., Mountain View, CA, USA., Taylor CA; HeartFlow, Inc., Mountain View, CA, USA., Yacoub H; Cardiology, Northwell Health Staten Island University Hospital, New York, NY, USA., Gupta H; Radiology, Valley Health System, Ridgewood, NJ, USA., Matsuo H; Medicine, Gifu Heart Center, Gifu, Japan., Rinehart S; Cardiology, Charleston Area Medical Center Memorial Hospital, Charleston, WV, USA., Maehara A; Cardiovascular Research Foundation, Columbia University, New York, NY, USA.
Jazyk:	angličtina
Zdroj:	European heart journal. Cardiovascular Imaging [Eur Heart J Cardiovasc Imaging] 2024 Aug 26; Vol. 25 (9), pp. 1287-1295.
DOI:	10.1093/ehjci/jeae115
Abstrakt:	Aims: Coronary computed tomography angiography provides non-invasive assessment of coronary stenosis severity and flow impairment. Automated artificial intelligence (AI) analysis may assist in precise quantification and characterization of coronary atherosclerosis, enabling patient-specific risk determination and management strategies. This multicentre international study compared an automated deep learning-based method for segmenting coronary atherosclerosis in coronary computed tomography angiography (CCTA) against the reference standard of intravascular ultrasound (IVUS). Methods and Results: The study included clinically stable patients with known coronary artery disease from 15 centres in the USA and Japan. An AI-enabled plaque analysis was utilized to quantify and characterize total plaque (TPV), vessel, lumen, calcified plaque (CP), non-calcified plaque (NCP), and low-attenuation plaque (LAP) volumes derived from CCTA and compared with IVUS measurements in a blinded, core laboratory-adjudicated fashion. In 237 patients, 432 lesions were assessed; mean lesion length was 24.5 mm, and mean IVUS-TPV was 186.0 mm3. AI-enabled plaque analysis on CCTA showed strong correlation and high accuracy when compared with IVUS; correlation coefficient, slope, and Y intercept for TPV were 0.91, 0.99, and 1.87, respectively; for CP volume 0.91, 1.05, and 5.32, respectively; and for NCP volume 0.87, 0.98, and 15.24, respectively. Bland-Altman analysis demonstrated strong agreement with little bias for these measurements. Conclusion: AI-enabled CCTA quantification and characterization of atherosclerosis demonstrated strong agreement with IVUS reference standard measurements. This tool may prove effective for accurate evaluation of coronary atherosclerotic burden and cardiovascular risk assessment. Competing Interests: Conflict of interest: J.N. has once received honorarium for serving in one meeting of HeartFlow scientific advisory board. J.L. is a HeartFlow consultant with stock options in the company. M.M. is a consultant for Boston Scientific and Terumo. S.R. is part of the Speakers Bureau of HeartFlow and Plaque Advisory Boards for Elucid and HeartFlow. A.M. is a consultant for Boston Scientific and SpectraWave. T.D.S., G.N., A.A., H.Y., H.G., and H.M. have no conflict of interest to disclose. K.P., Sab.M., N.N., Sar.M., M.S., C.R., and C.A.T. are full-time HeartFlow employees with salary and equity in the company. (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Databáze:	MEDLINE
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