AHA classification of coronary and carotid atherosclerotic plaques by grating-based phase-contrast computed tomography
Hetterich H, Webber N, Willner M, Herzen J, Birnbacher L, Hipp A, Marschner M, Auweter SD, Habbel C, Schueller U, Bamberg F, Ertl-Wagner B, Pfeiffer F, Saam T (2016)
Publication Type: Journal article
Publication year: 2016
Journal
Book Volume: 26
Pages Range: 3223-3233
Journal Issue: 9
DOI: 10.1007/s00330-015-4143-z
Abstract
Objectives: To evaluate the potential of grating-based phase-contrast computed-tomography (gb-PCCT) to classify human carotid and coronary atherosclerotic plaques according to modified American Heart Association (AHA) criteria. Methods: Experiments were carried out at a laboratory-based set-up consisting of X-ray tube (40 kVp), grating-interferometer and detector. Eighteen human carotid and coronary artery specimens were examined. Histopathology served as the standard of reference. Vessel cross-sections were classified as AHA lesion type I/II, III, IV/V, VI, VII or VIII plaques by two independent reviewers blinded to histopathology. Conservative measurements of diagnostic accuracies for the detection and differentiation of plaque types were evaluated. Results: A total of 127 corresponding gb-PCCT/histopathology sections were analyzed. Based on histopathology, lesion type I/II was present in 12 (9.5 %), III in 18 (14.2 %), IV/V in 38 (29.9 %), VI in 16 (12.6 %), VII in 34 (26.8 %) and VIII in 9 (7.0 %) cross-sections. Sensitivity, specificity and positive and negative predictive value were ≥0.88 for most analyzed plaque types with a good level of agreement (Cohen’s kappa = 0.90). Overall, results were better in carotid (kappa = 0.97) than in coronary arteries (kappa = 0.85). Inter-observer agreement was high with kappa = 0.85, p < 0.0001. Conclusions: These results indicate that gb-PCCT can reliably classify atherosclerotic plaques according to modified AHA criteria with excellent agreement to histopathology. Key Points: • Different atherosclerotic plaque types display distinct morphological features in phase-contrast CT. • Phase-contrast CT can detect and differentiate AHA plaque types. • Calcifications caused streak artefacts and reduced sensitivity in type VI lesions. • Overall agreement was higher in carotid than in coronary arteries.
Involved external institutions
Technische Universität München (TUM)
Germany (DE)
Universitätsklinikum der Ludwig-Maximilians-Universität München
Germany (DE)
Germany (DE)
Universitätsklinikum der Ludwig-Maximilians-Universität München
Germany (DE)
How to cite
APA:
Hetterich, H., Webber, N., Willner, M., Herzen, J., Birnbacher, L., Hipp, A.,... Saam, T. (2016). AHA classification of coronary and carotid atherosclerotic plaques by grating-based phase-contrast computed tomography. European Radiology, 26(9), 3223-3233. https://doi.org/10.1007/s00330-015-4143-z
MLA:
Hetterich, Holger, et al. "AHA classification of coronary and carotid atherosclerotic plaques by grating-based phase-contrast computed tomography." European Radiology 26.9 (2016): 3223-3233.
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