Quantitative coronary plaque analysis predicts high-risk plaque morphology on coronary computed tomography angiography: results from the ROMICAT II trial

Ting Liu, Pál Maurovich-Horvat, Thomas Mayrhofer, Stefan B. Puchner, Michael T. Lu, Khristine Ghemigian, Pieter H. Kitslaar, Alexander Broersen, Amit Pursnani, Udo Hoffmann, Maros Ferencik

    Research output: Contribution to journalArticle

    7 Citations (Scopus)

    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.

    Original languageEnglish (US)
    Pages (from-to)1-9
    Number of pages9
    JournalInternational Journal of Cardiovascular Imaging
    DOIs
    StateAccepted/In press - Aug 12 2017

    Fingerprint

    Myocardial Ischemia
    Myocardial Infarction
    Tomography
    Coronary Angiography
    Odds Ratio
    Software
    Cone-Beam Computed Tomography
    Atherosclerotic Plaques
    Computed Tomography Angiography
    Pathologic Constriction
    Logistic Models
    Regression Analysis
    Calcium

    Keywords

    • Coronary atherosclerosis
    • Coronary CT angiography
    • High-risk coronary plaque
    • Quantitative assessment

    ASJC Scopus subject areas

    • Radiology Nuclear Medicine and imaging
    • Cardiology and Cardiovascular Medicine

    Cite this

    Quantitative coronary plaque analysis predicts high-risk plaque morphology on coronary computed tomography angiography : results from the ROMICAT II trial. / Liu, Ting; Maurovich-Horvat, Pál; Mayrhofer, Thomas; Puchner, Stefan B.; Lu, Michael T.; Ghemigian, Khristine; Kitslaar, Pieter H.; Broersen, Alexander; Pursnani, Amit; Hoffmann, Udo; Ferencik, Maros.

    In: International Journal of Cardiovascular Imaging, 12.08.2017, p. 1-9.

    Research output: Contribution to journalArticle

    Liu, Ting ; Maurovich-Horvat, Pál ; Mayrhofer, Thomas ; Puchner, Stefan B. ; Lu, Michael T. ; Ghemigian, Khristine ; Kitslaar, Pieter H. ; Broersen, Alexander ; Pursnani, Amit ; Hoffmann, Udo ; Ferencik, Maros. / Quantitative coronary plaque analysis predicts high-risk plaque morphology on coronary computed tomography angiography : results from the ROMICAT II trial. In: International Journal of Cardiovascular Imaging. 2017 ; pp. 1-9.
    @article{19ffae6a377e46b5bcc6de7be21d1ffe,
    title = "Quantitative coronary plaque analysis predicts high-risk plaque morphology on coronary computed tomography angiography: results from the ROMICAT II trial",
    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.",
    keywords = "Coronary atherosclerosis, Coronary CT angiography, High-risk coronary plaque, Quantitative assessment",
    author = "Ting Liu and P{\'a}l Maurovich-Horvat and Thomas Mayrhofer and Puchner, {Stefan B.} and Lu, {Michael T.} and Khristine Ghemigian and Kitslaar, {Pieter H.} and Alexander Broersen and Amit Pursnani and Udo Hoffmann and Maros Ferencik",
    year = "2017",
    month = "8",
    day = "12",
    doi = "10.1007/s10554-017-1228-6",
    language = "English (US)",
    pages = "1--9",
    journal = "International Journal of Cardiovascular Imaging",
    issn = "1569-5794",
    publisher = "Springer Netherlands",

    }

    TY - JOUR

    T1 - Quantitative coronary plaque analysis predicts high-risk plaque morphology on coronary computed tomography angiography

    T2 - 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

    PY - 2017/8/12

    Y1 - 2017/8/12

    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.

    AB - 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.

    KW - Coronary atherosclerosis

    KW - Coronary CT angiography

    KW - High-risk coronary plaque

    KW - Quantitative assessment

    UR - http://www.scopus.com/inward/record.url?scp=85027336838&partnerID=8YFLogxK

    UR - http://www.scopus.com/inward/citedby.url?scp=85027336838&partnerID=8YFLogxK

    U2 - 10.1007/s10554-017-1228-6

    DO - 10.1007/s10554-017-1228-6

    M3 - Article

    C2 - 28803421

    AN - SCOPUS:85027336838

    SP - 1

    EP - 9

    JO - International Journal of Cardiovascular Imaging

    JF - International Journal of Cardiovascular Imaging

    SN - 1569-5794

    ER -