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Quantitative coronary plaque analysis predicts high-risk plaque morphology on coronary computed tomography angiography: results from the ROMICAT II trial.
Int J Cardiovasc Imaging. 2018 Feb; 34(2):311-319.IJ

Abstract

Semi-automated software can provide quantitative assessment of atherosclerotic plaques on coronary CT angiography (CTA). The relationship between established qualitative high-risk plaque features and quantitative plaque measurements has not been studied. We analyzed the association between quantitative plaque measurements and qualitative high-risk plaque features on coronary CTA. We included 260 patients with plaque who underwent coronary CTA in the Rule Out Myocardial Infarction/Ischemia Using Computer Assisted Tomography (ROMICAT) II trial. Quantitative plaque assessment and qualitative plaque characterization were performed on a per coronary segment basis. Quantitative coronary plaque measurements included plaque volume, plaque burden, remodeling index, and diameter stenosis. In qualitative analysis, high-risk plaque was present if positive remodeling, low CT attenuation plaque, napkin-ring sign or spotty calcium were detected. Univariable and multivariable logistic regression analyses were performed to assess the association between quantitative and qualitative high-risk plaque assessment. Among 888 segments with coronary plaque, high-risk plaque was present in 391 (44.0%) segments by qualitative analysis. In quantitative analysis, segments with high-risk plaque had higher total plaque volume, low CT attenuation plaque volume, plaque burden and remodeling index. Quantitatively assessed low CT attenuation plaque volume (odds ratio 1.12 per 1 mm3, 95% CI 1.04-1.21), positive remodeling (odds ratio 1.25 per 0.1, 95% CI 1.10-1.41) and plaque burden (odds ratio 1.53 per 0.1, 95% CI 1.08-2.16) were associated with high-risk plaque. Quantitative coronary plaque characteristics (low CT attenuation plaque volume, positive remodeling and plaque burden) measured by semi-automated software correlated with qualitative assessment of high-risk plaque features.

Authors+Show Affiliations

Department of Radiology, First Affiliated Hospital of China Medical University, 110001, Shenyang, China. cmuliuting@sina.cn. Cardiac MR PET CT Program, Division of Cardiology and Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA. cmuliuting@sina.cn.Cardiac MR PET CT Program, Division of Cardiology and Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA. MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary.Cardiac MR PET CT Program, Division of Cardiology and Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA. School of Business Studies, Stralsund University of Applied Sciences, Stralsund, Germany.Cardiac MR PET CT Program, Division of Cardiology and Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA. Department of Biomedical Imaging and Image-Guided Therapy, Medical University Vienna, Vienna, Austria.Cardiac MR PET CT Program, Division of Cardiology and Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.Cardiac MR PET CT Program, Division of Cardiology and Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.Department of Radiology, Division of Image Processing, Leiden University Medical Center, Leiden, The Netherlands. Medis Medical Imaging Systems B.V, Leiden, The Netherlands.Department of Radiology, Division of Image Processing, Leiden University Medical Center, Leiden, The Netherlands.Cardiac MR PET CT Program, Division of Cardiology and Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.Cardiac MR PET CT Program, Division of Cardiology and Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.Cardiac MR PET CT Program, Division of Cardiology and Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA. Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, USA.

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

28803421

Citation

Liu, Ting, et al. "Quantitative Coronary Plaque Analysis Predicts High-risk Plaque Morphology On Coronary Computed Tomography Angiography: Results From the ROMICAT II Trial." The International Journal of Cardiovascular Imaging, vol. 34, no. 2, 2018, pp. 311-319.
Liu T, Maurovich-Horvat P, Mayrhofer T, et al. Quantitative coronary plaque analysis predicts high-risk plaque morphology on coronary computed tomography angiography: results from the ROMICAT II trial. Int J Cardiovasc Imaging. 2018;34(2):311-319.
Liu, T., Maurovich-Horvat, P., Mayrhofer, T., Puchner, S. B., Lu, M. T., Ghemigian, K., Kitslaar, P. H., Broersen, A., Pursnani, A., Hoffmann, U., & Ferencik, M. (2018). Quantitative coronary plaque analysis predicts high-risk plaque morphology on coronary computed tomography angiography: results from the ROMICAT II trial. The International Journal of Cardiovascular Imaging, 34(2), 311-319. https://doi.org/10.1007/s10554-017-1228-6
Liu T, et al. Quantitative Coronary Plaque Analysis Predicts High-risk Plaque Morphology On Coronary Computed Tomography Angiography: Results From the ROMICAT II Trial. Int J Cardiovasc Imaging. 2018;34(2):311-319. PubMed PMID: 28803421.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Quantitative coronary plaque analysis predicts high-risk plaque morphology on coronary computed tomography angiography: results from the ROMICAT II trial. AU - Liu,Ting, AU - Maurovich-Horvat,Pál, AU - Mayrhofer,Thomas, AU - Puchner,Stefan B, AU - Lu,Michael T, AU - Ghemigian,Khristine, AU - Kitslaar,Pieter H, AU - Broersen,Alexander, AU - Pursnani,Amit, AU - Hoffmann,Udo, AU - Ferencik,Maros, Y1 - 2017/08/12/ PY - 2017/07/04/received PY - 2017/08/07/accepted PY - 2017/8/15/pubmed PY - 2018/8/28/medline PY - 2017/8/14/entrez KW - Coronary CT angiography KW - Coronary atherosclerosis KW - High-risk coronary plaque KW - Quantitative assessment SP - 311 EP - 319 JF - The international journal of cardiovascular imaging JO - Int J Cardiovasc Imaging VL - 34 IS - 2 N2 - Semi-automated software can provide quantitative assessment of atherosclerotic plaques on coronary CT angiography (CTA). The relationship between established qualitative high-risk plaque features and quantitative plaque measurements has not been studied. We analyzed the association between quantitative plaque measurements and qualitative high-risk plaque features on coronary CTA. We included 260 patients with plaque who underwent coronary CTA in the Rule Out Myocardial Infarction/Ischemia Using Computer Assisted Tomography (ROMICAT) II trial. Quantitative plaque assessment and qualitative plaque characterization were performed on a per coronary segment basis. Quantitative coronary plaque measurements included plaque volume, plaque burden, remodeling index, and diameter stenosis. In qualitative analysis, high-risk plaque was present if positive remodeling, low CT attenuation plaque, napkin-ring sign or spotty calcium were detected. Univariable and multivariable logistic regression analyses were performed to assess the association between quantitative and qualitative high-risk plaque assessment. Among 888 segments with coronary plaque, high-risk plaque was present in 391 (44.0%) segments by qualitative analysis. In quantitative analysis, segments with high-risk plaque had higher total plaque volume, low CT attenuation plaque volume, plaque burden and remodeling index. Quantitatively assessed low CT attenuation plaque volume (odds ratio 1.12 per 1 mm3, 95% CI 1.04-1.21), positive remodeling (odds ratio 1.25 per 0.1, 95% CI 1.10-1.41) and plaque burden (odds ratio 1.53 per 0.1, 95% CI 1.08-2.16) were associated with high-risk plaque. Quantitative coronary plaque characteristics (low CT attenuation plaque volume, positive remodeling and plaque burden) measured by semi-automated software correlated with qualitative assessment of high-risk plaque features. SN - 1875-8312 UR - https://www.unboundmedicine.com/medline/citation/28803421/Quantitative_coronary_plaque_analysis_predicts_high_risk_plaque_morphology_on_coronary_computed_tomography_angiography:_results_from_the_ROMICAT_II_trial_ L2 - https://doi.org/10.1007/s10554-017-1228-6 DB - PRIME DP - Unbound Medicine ER -