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Accuracy and limitation of plaque detection by coronary CTA: a section-to-section comparison with optical coherence tomography
Plaques identified by Coronary CT angiography (CCTA) are important in clinical diagnosis and primary prevention. High-risk plaque features by CCTA have been extensively validated using optical coherence tomography (OCT). However, since their general diagnostic performance and limitations have not be...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Nature Publishing Group UK
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10363114/ https://www.ncbi.nlm.nih.gov/pubmed/37481671 http://dx.doi.org/10.1038/s41598-023-38675-9 |
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author | Cao, J. Jane Shen, Linghong Nguyen, James Rapelje, Kathleen Porter, Craig Shlofmitz, Evan Jeremias, Allen Cohen, David J. Ali, Ziad A. Shlofmitz, Richard |
author_facet | Cao, J. Jane Shen, Linghong Nguyen, James Rapelje, Kathleen Porter, Craig Shlofmitz, Evan Jeremias, Allen Cohen, David J. Ali, Ziad A. Shlofmitz, Richard |
author_sort | Cao, J. Jane |
collection | PubMed |
description | Plaques identified by Coronary CT angiography (CCTA) are important in clinical diagnosis and primary prevention. High-risk plaque features by CCTA have been extensively validated using optical coherence tomography (OCT). However, since their general diagnostic performance and limitations have not been fully investigated, we sought to compare CCTA with OCT among consecutive vessel sections. We retrospectively compared 188 consecutive plaques and 84 normal sections in 41 vessels from 40 consecutive patients referred for chest pain evaluation who had both CCTA and OCT with a median time lapse of 1 day. The distance to reference points were used to co-register between the modalities and the diagnostic performance of CCTA was evaluated against OCT. Plaque categories evaluated by CT were calcified, non-calcified and mixed. The diagnostic performance of CCTA was excellent for detecting any plaque identified by OCT with the sensitivity, specificity, negative and positive predictive values and accuracy of 92%, 98%, 99%, 84% and 93%, respectively. The lower than expected negative predictive value was due to failure of detecting sub-millimeter calcified (≤ 0.25 mm(2)) (N = 12) and non-calcified plaques (N = 4). Misclassification of plaque type accounted for majority of false negative findings (25/41, 61%) which was most prevalent among the mixed plaque (19/41, 46%). There was calcification within mixed plaques (N = 5) seen by CCTA but missed by OCT. Our findings suggest that CCTA is excellent at identifying coronary plaques except those sub-millimeter in size which likely represent very early atherosclerosis, although the clinical implication of very mild atherosclerosis is yet to be determined. |
format | Online Article Text |
id | pubmed-10363114 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-103631142023-07-24 Accuracy and limitation of plaque detection by coronary CTA: a section-to-section comparison with optical coherence tomography Cao, J. Jane Shen, Linghong Nguyen, James Rapelje, Kathleen Porter, Craig Shlofmitz, Evan Jeremias, Allen Cohen, David J. Ali, Ziad A. Shlofmitz, Richard Sci Rep Article Plaques identified by Coronary CT angiography (CCTA) are important in clinical diagnosis and primary prevention. High-risk plaque features by CCTA have been extensively validated using optical coherence tomography (OCT). However, since their general diagnostic performance and limitations have not been fully investigated, we sought to compare CCTA with OCT among consecutive vessel sections. We retrospectively compared 188 consecutive plaques and 84 normal sections in 41 vessels from 40 consecutive patients referred for chest pain evaluation who had both CCTA and OCT with a median time lapse of 1 day. The distance to reference points were used to co-register between the modalities and the diagnostic performance of CCTA was evaluated against OCT. Plaque categories evaluated by CT were calcified, non-calcified and mixed. The diagnostic performance of CCTA was excellent for detecting any plaque identified by OCT with the sensitivity, specificity, negative and positive predictive values and accuracy of 92%, 98%, 99%, 84% and 93%, respectively. The lower than expected negative predictive value was due to failure of detecting sub-millimeter calcified (≤ 0.25 mm(2)) (N = 12) and non-calcified plaques (N = 4). Misclassification of plaque type accounted for majority of false negative findings (25/41, 61%) which was most prevalent among the mixed plaque (19/41, 46%). There was calcification within mixed plaques (N = 5) seen by CCTA but missed by OCT. Our findings suggest that CCTA is excellent at identifying coronary plaques except those sub-millimeter in size which likely represent very early atherosclerosis, although the clinical implication of very mild atherosclerosis is yet to be determined. Nature Publishing Group UK 2023-07-22 /pmc/articles/PMC10363114/ /pubmed/37481671 http://dx.doi.org/10.1038/s41598-023-38675-9 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Cao, J. Jane Shen, Linghong Nguyen, James Rapelje, Kathleen Porter, Craig Shlofmitz, Evan Jeremias, Allen Cohen, David J. Ali, Ziad A. Shlofmitz, Richard Accuracy and limitation of plaque detection by coronary CTA: a section-to-section comparison with optical coherence tomography |
title | Accuracy and limitation of plaque detection by coronary CTA: a section-to-section comparison with optical coherence tomography |
title_full | Accuracy and limitation of plaque detection by coronary CTA: a section-to-section comparison with optical coherence tomography |
title_fullStr | Accuracy and limitation of plaque detection by coronary CTA: a section-to-section comparison with optical coherence tomography |
title_full_unstemmed | Accuracy and limitation of plaque detection by coronary CTA: a section-to-section comparison with optical coherence tomography |
title_short | Accuracy and limitation of plaque detection by coronary CTA: a section-to-section comparison with optical coherence tomography |
title_sort | accuracy and limitation of plaque detection by coronary cta: a section-to-section comparison with optical coherence tomography |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10363114/ https://www.ncbi.nlm.nih.gov/pubmed/37481671 http://dx.doi.org/10.1038/s41598-023-38675-9 |
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