Clinical application of effective atomic number for classifying non-calcified coronary plaques by dual-energy computed tomography

Autor: Hiroshi Sakura, Kazuhiro Matsui, Hiroyuki Ito, Hisako Omori, Eiko Ueno, Rika Fukui, Takashi Nakaoka, Haruhiko Machida, Yutaka Kubo, Tetsuya Mitsuhashi, Isao Tanaka, Shun Nakajima
Rok vydání: 2017
Předmět:
Adult
Male
medicine.medical_specialty
Acute coronary syndrome
Computed Tomography Angiography
Coronary Artery Disease
030204 cardiovascular system & hematology
Coronary Angiography
Radiation Dosage
Severity of Illness Index
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
Hounsfield scale
Fibrous plaque
Humans
Medicine
Cutoff
Prospective Studies
Ultrasonography
Interventional
Aged
medicine.diagnostic_test
business.industry
Reproducibility of Results
Dual-Energy Computed Tomography
Middle Aged
Radiation Exposure
medicine.disease
Coronary Vessels
Fibrosis
Plaque
Atherosclerotic
Coronary arteries
medicine.anatomical_structure
ROC Curve
Area Under Curve
Angiography
Radiographic Image Interpretation
Computer-Assisted
Female
Radiology
business
Nuclear medicine
Cardiology and Cardiovascular Medicine
Effective atomic number
Zdroj: Atherosclerosis.
ISSN: 0021-9150
DOI: 10.1016/j.atherosclerosis.2017.03.025
Popis: Coronary computed tomography (CT) angiography allows non-invasive classification of non-calcified coronary plaques (NCCPs) based on Hounsfield unit (HU) values. This methodology, however, is somewhat limited for reliable classification of NCCPs. Therefore, we evaluated the effective atomic number (EAN) for classifying NCCPs by single-source dual-energy CT with fast tube voltage switching (SSDECT).We prospectively enrolled 18 patients undergoing both SSDECT and intravascular ultrasonography (IVUS). Monochromatic images at 70 keV and EAN images were reconstructed from SSDECT data sets. Regions of interest (ROIs) within NCCPs were placed on IVUS-matched SSDECT images, and mean HU values and EANs for soft and fibrous plaques, classified using IVUS, were compared with an unpaired t-test.We placed 96 ROIs in 29 soft plaques and 37 ROIs in 15 fibrous plaques in 12 coronary arteries of 11 patients. The mean HU value in soft plaques (58.2 ± 32.8 HU) was significantly lower than that in fibrous plaques (103.9 ± 48.3 HU) (p 0.001). The mean EAN in soft plaques (8.7 ± 0.5) was also significantly lower than that in fibrous plaques (9.6 ± 0.5) (p 0.0001). Area under the curve for EAN (0.91) was significantly higher than that for HU value (0.79) in receiver operating characteristic curve analysis (p = 0.046). With a cutoff EAN of 9.3, sensitivity was 90% and specificity, 87%; whereas with a cutoff HU value of 55.0 HU, sensitivity was 62% and specificity, 93%.EAN measurement by SSDECT can be clinically useful for accurately classifying soft and fibrous coronary plaques.
Databáze: OpenAIRE
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