Comments on: Coronary Plaque Imaging With 256-Slice Multidetector Computed Tomography: Interobserver Variability of Volumetric Lesion Parameters with Semiautomatic Plaque Analysis Software

By: Paul Schoenhagen, MD

Paul Schoenhagen, MD — Fri, 02 Apr 2010 03:17:41 +0000

Also check the recent publication about this topic with dual source technology:

Quantification of non-calcified coronary atherosclerotic plaques with dual-source computed tomography: comparison with intravascular ultrasound.
Tiziano Schepis, Mohamed Marwan, Tobias Pflederer, Martin Seltmann, Dieter Ropers, Werner G Daniel, Stephan Achenbach.
Heart 2010;96 610-615
PMID: 19933294

By: Paul Schoenhagen, MD

Paul Schoenhagen, MD — Tue, 30 Mar 2010 19:37:08 +0000

Read the following article by Chopard et al, which is quite critical about the current role of CT for plaque imaging:

- How reliable are 40 MHz IVUS and 64-slice MDCT in characterizing coronary plaque composition? An ex vivo study with histopathological comparison.
Chopard R, Boussel L, Motreff P, Rioufol G, Tabib A, Douek P, Meyronet D, Revel D, Finet G.
Int J Cardiovasc Imaging. 2010 Jan 6.
PMID: 20052618

Also a more systematic review:

- Comparison of multislice computed tomography with intravascular ultrasound for detection and characterization of coronary artery plaques: a systematic review.
Springer I, Dewey M.
Eur J Radiol. 2009 Aug;71(2):275-82. Review.
PMID: 18586427

By: Jacobo Kirsch, MD

Jacobo Kirsch, MD — Mon, 29 Mar 2010 18:53:49 +0000

The purpose of this study was to evaluate the potential clinical value of coronary plaque imaging with a new generation CT scanner and the interobserver variability of semiautomatic coronary plaque assessment with a new software application. The study was done in a population of 35 patients that resulted in 35 different lesions for analysis.

In this small cohort, a large interobserver bias and variability for all lesions was found for lesion volume, maximum plaque burden, and lesion mean HU; however, much smaller differences existed for relative lesion composition. Specifically, for all lesion parameters, larger interobserver bias and variability existed for calcified and mixed lesions when compared to non-calcified lesions. This leads me to ponder if we still need to learn how to deal with calcium ‘blooming’ artifact, either manually or (definitely) automatically. Are new algorithms that recognize a gradual or algorithmic change of pixels surrounding calcified plaque necessary to recognize this artifact?

Nice study on a small group of lesions that may serve as added data to the topic of plaque composition analysis. However, very few lesions using not only a new method, but also a new technology, and with no gold-standard to compare the findings seems very premature as self-standing results to rely on.

By: Ronen Rubinshtein, MD

Ronen Rubinshtein, MD — Sun, 28 Mar 2010 13:19:38 +0000

The manuscript described the advantages, but also the limitations of a semi-automatic plaque analysis software. Evaluation of plaque volume (or “burden”) by CT is still challenging.