AHA classification of coronary and carotid atherosclerotic plaques by grating-based phase-contrast computed tomography
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AHA classification of coronary and carotid atherosclerotic plaques by grating-based phase-contrast computed tomography. / Hetterich, Holger; Webber, Nicole; Willner, Marian; Herzen, Julia; Birnbacher, Lorenz; Hipp, Alexander; Marschner, Mathias; Auweter, Sigrid D; Habbel, Christopher; Schüller, Ulrich; Bamberg, Fabian; Ertl-Wagner, Birgit; Pfeiffer, Franz; Saam, Tobias.
in: EUR RADIOL, Jahrgang 26, Nr. 9, 09.2016, S. 3223-33.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - AHA classification of coronary and carotid atherosclerotic plaques by grating-based phase-contrast computed tomography
AU - Hetterich, Holger
AU - Webber, Nicole
AU - Willner, Marian
AU - Herzen, Julia
AU - Birnbacher, Lorenz
AU - Hipp, Alexander
AU - Marschner, Mathias
AU - Auweter, Sigrid D
AU - Habbel, Christopher
AU - Schüller, Ulrich
AU - Bamberg, Fabian
AU - Ertl-Wagner, Birgit
AU - Pfeiffer, Franz
AU - Saam, Tobias
PY - 2016/9
Y1 - 2016/9
N2 - 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.
AB - 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.
KW - Aged
KW - Aged, 80 and over
KW - American Heart Association
KW - Carotid Arteries
KW - Coronary Vessels
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Observer Variation
KW - Plaque, Atherosclerotic
KW - Prospective Studies
KW - Radiographic Image Interpretation, Computer-Assisted
KW - Reproducibility of Results
KW - Sensitivity and Specificity
KW - Tomography, X-Ray Computed
KW - United States
KW - Journal Article
U2 - 10.1007/s00330-015-4143-z
DO - 10.1007/s00330-015-4143-z
M3 - SCORING: Journal article
C2 - 26679184
VL - 26
SP - 3223
EP - 3233
JO - EUR RADIOL
JF - EUR RADIOL
SN - 0938-7994
IS - 9
ER -
