Evaluation of adverse plaque characteristics in coronary computed tomography angiography using combined near infrared spectroscopy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Shin
Keyword(s):  
Computed Tomography ◽  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Computed Tomography Angiography ◽  
Near Infrared ◽  
Coronary Computed Tomography Angiography ◽  
Coronary Intervention ◽  
Cross Sectional ◽  
Coronary Computed Tomography ◽  
Significant Difference

Abstract Background/Introduction Coronary computed tomography angiography (CCTA) has developed rapidly, enabling the evaluation of coronary stenosis as well as plaque characteristics. However, it is not clear whether the adverse plaque characteristics found in CCTA are really vulnerable plaques. Near-infrared spectroscopy (NIRS) is able to quantify cholesterol within coronary arteries by the lipid core burden index (LCBI). Purpose The purpose of this study was to determine whether positive remodeling (PR), low attenuated plaque (LAP) and spotty calcificaiton (SC) found in CCTA have high LCBI values in NIRS. Methods The study was single center, prospective, and cross-sectional. A total of 84 patients who underwent NIRS during percutaneous coronary intervention after CCTA imaging for coronary artery disease were studied. PR, LAP and SC were identified in the plaques visible on CCTA, and LCBI and maxLCBI (4mm) were measured by NIRS on the same plaque. Results In the presence of PR and LAP in the plaque, the maxLCBI (4mm) [PR: 468±161 vs. 319±214, p=0.032, LAP: 475±178 vs. 278±191, p=0.006] and LCBI [PR: 190±74 vs. 132±104, p=0.044, LAP: 182±96 vs. 124±93, p=0.038] values were significantly higher than those in the plaque without PR and LAP. However, with and without SC, there was no significant difference between the maxLCBI (4mm) [474±181 vs. 336±208] and LCBI [183±77 vs. 142±102, p=0.127] values. Conclusion Among the adverse plaque characteristics found in CCTA, PR and LAP were clearly correlated with maxLCBI (4mm) and LCBI measured by NIRS, but SC was less correlated. APC vs. LCBI Funding Acknowledgement Type of funding source: None

Abstract 15178: The Clinical Characteristics of Patients With Ischemia-oriented or Coronary Computed Tomography Angiography-oriented Percutaneous Coronary Intervention, a Report From the Multicenter Registry

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Jun Fujita ◽  
Shun Kohsaka ◽  
Ikuko Ueda ◽  
Taku Inohara ◽  
Yuichiro Maekawa ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Percutaneous Coronary Intervention ◽  
Computed Tomography Angiography ◽  
Clinical Characteristics ◽  
Coronary Computed Tomography Angiography ◽  
Coronary Intervention ◽  
Coronary Computed Tomography ◽  
Ischemic Region ◽  
Percutaneous Coronary ◽  
Incomplete Revascularization

Background: Myocardial perfusion scintigraphy (MPS) plays a pivotal role in the evaluation of ischemia. Coronary computed tomography angiography (CTA) is emerging to evaluate anatomical features for stable ischemic heart disease (SIHD). This study aimed to identify the clinical characteristics of ischemia (MPS) or anatomy (CTA)-oriented percutaneous coronary intervention (PCI) patients for SIHD. Methods and Results: Data were analyzed from 4197 SIHD patients undergoing PCI in The Japan Cardiovascular Database (N = 11,258) between September 2008 and April 2013. MPS was used to evaluate 1070 (25.5%) patients. Significant ischemia (SI) was defined as more than 10% ischemic region. CTA was performed in 1433 patients, and patients with ischemia evaluation and unavailable results were excluded. A total of 694 patients (16.5%) were evaluated as CTA group. CTA-oriented PCI patients had milder illness in their background (Table). More than half of patients had multivessel disease (CTA vs non-SI vs SI; 51.6, 66.3, 71.9%). Incomplete revascularization ratio was significantly lower in CTA group (0.6, 2.2, 3.1%, p = 0.003). However, CTA-oriented PCI patients and SI patients had significantly more complications than non-SI patients (6.6, 3.8, 8.2%, p = 0.022), especially post-procedural infarction (2.4, 0.5, 3.0%, p = 0.032) (Figure). Conclusions: Even though CTA-oriented PCI patients had incomplete revascularization less frequently, they experienced more complications. These results indicate that functional assessment is important to predict in-hospital complications, and physicians need to give their attention to CTA-oriented PCI patients as well as SI patients.

scholarly journals Comparison of image quality and radiation dose using different pre-ASiR-V and post-ASiR-V levels in coronary computed tomography angiography

2020 ◽  
pp. 1-10
Author(s):  
Yongxia Zhao ◽  
Dongxue Li ◽  
Zhichao Liu ◽  
Xue Geng ◽  
Tianle Zhang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Image Quality ◽  
Radiation Dose ◽  
Computed Tomography Angiography ◽  
Coronary Computed Tomography Angiography ◽  
Effective Radiation Dose ◽  
Dose Length Product ◽  
Coronary Computed Tomography ◽  
Significant Difference ◽  
Noise Ratio

OBJECTIVE: To determine the optimal pre-adaptive and post-adaptive level statistical iterative reconstruction V (ASiR-V) for improving image quality and reducing radiation dose in coronary computed tomography angiography (CCTA). METHODS: The study was divided into two parts. In part I, 150 patients for CCTA were prospectively enrolled and randomly divided into 5 groups (A, B, C, D, and E) with progressive scanning from 40% to 80% pre-ASiR-V with 10% intervals and reconstructing with 70% post-ASiR-V. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Subjective image quality was assessed using a 5-point scale. The CT dose index volume (CTDIvol) and dose-length product (DLP) of each patient were recorded and the effective radiation dose (ED) was calculated after statistical analysis by optimizing for the best pre-ASiR-V value with the lowest radiation dose while maintaining overall image quality. In part II, the images were reconstructed with the recommended optimal pre-ASiR-V values in part I (D group) and 40%–90% of post-ASiR-V. The reconstruction group (D group) was divided into 6 subgroups (interval 10%, D0:40% post-ASiR-V, D1:50% post - ASiR-V, D2:60% post-ASiR-V, D3:70% post-ASiR-V, D4:80% post-ASiR-V, and D5:90% post-ASiR-V).The SNR and CNR of D0-D5 subgroups were calculated and analyzed using one-way analysis of variance, and the consistency of the subjective scores used the k test. RESULTS: There was no significant difference in the SNRs, CNRs, and image quality scores among A, B, C, and D groups (P > 0.05). The SNR, CNR, and image quality scores of the E group were lower than those of the A, B, C, and D groups (P < 0.05). The mean EDs in the B, C, and D groups were reduced by 7.01%, 13.37%, and 18.87%, respectively, when compared with that of the A group. The SNR and CNR of the D4–D5 subgroups were higher than the D0-D3 subgroups, and the image quality scores of the D4 subgroups were higher than the other subgroups (P < 0.05). CONCLUSION: The wide-detector combined with 70% pre-ASiR-V and 80% post-ASiR-V significantly reduces the radiation dose of CCTA while maintaining overall image quality as compared with the manufacture’s recommendation of 40% pre-ASiR-V.

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