Quantification of nonculprit coronary lesions: Comparison of cardiac 64-MDCT and invasive coronary angiography

Jonathan D. Dodd, Johannes Rieber, Eugene Pomerantsev, Vithaya Chaithiraphan, Stephan Achenbach, Javier M. Moreiras, Suhny Abbara, Udo Hoffmann, Thomas J. Brady, Ricardo C. Cury

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

OBJECTIVE. The purpose of our study was to evaluate the accuracy of cardiac 64-MDCT to quantify the grade of stenosis of nonculprit lesions. SUBJECTS AND METHODS. Twenty-nine consecutive patients (23 men and six women; mean age, 62 ± 10 years) presenting with acute coronary syndrome (ACS) had nonculprit coronary lesions of ≥ 30% stenosis quantified on quantitative coronary angiography (QCA). Five 64-MDCT postprocessing techniques (maximum intensity projection [MIP], multiplanar reformat [MPR], cross-sectional area [CSA], and diameter and area derived from semiquantitative coronary software) were used to grade lesions. Two separate groups of two independent readers analyzed QCA and cardiac CT images using a 17-segment model. Coronary angiography was the reference standard. RESULTS. Nonculprit lesions were identified in 46 analyzable coronary segments. Subgrouping lesions on the basis of reference vessel diameter resulted in strong correlations for quantifying nonculprit lesions in vessels > 3 mm (R = 0.78-0.91, p < 0.01) but poor correlations for nonculprit lesions in vessels ≤ 3 mm (R = 0.1-0.07). Subgrouping lesions on the basis of plaque type resulted in poor correlations for calcified plaques (R = 0.01-0.30) but moderate to strong correlations for mixed (R = 0.58-0.75, p < 0.01) and noncalcified (R = 0.44-0.61, p < 0.01) plaques. The best overall correlation among all CT techniques with QCA was CSA (R = 0.56, p < 0.01). Interobserver agreement (kappa values) for MPR, MIP, coronary software diameter and area were 0.6, 0.7, 0.62, and 0.57, respectively. CONCLUSION. In patients presenting with ACS, 64-MDCT provided an accurate grade of stenosis for nonculprit coronary lesions in proximal coronary segments. Calcified plaques and lesions in coronary segments ≤ 3 mm diameter remained difficult to accurately quantify.

Original languageEnglish (US)
Pages (from-to)432-438
Number of pages7
JournalAmerican Journal of Roentgenology
Volume191
Issue number2
DOIs
StatePublished - 2008

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Coronary Angiography
Acute Coronary Syndrome
Pathologic Constriction
Software
Coronary Stenosis

Keywords

  • Coronary angiography
  • Coronary stenosis
  • CT
  • Myocardial infarction
  • Nonculprit coronary lesion

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Dodd, J. D., Rieber, J., Pomerantsev, E., Chaithiraphan, V., Achenbach, S., Moreiras, J. M., ... Cury, R. C. (2008). Quantification of nonculprit coronary lesions: Comparison of cardiac 64-MDCT and invasive coronary angiography. American Journal of Roentgenology, 191(2), 432-438. https://doi.org/10.2214/AJR.07.3315

Quantification of nonculprit coronary lesions : Comparison of cardiac 64-MDCT and invasive coronary angiography. / Dodd, Jonathan D.; Rieber, Johannes; Pomerantsev, Eugene; Chaithiraphan, Vithaya; Achenbach, Stephan; Moreiras, Javier M.; Abbara, Suhny; Hoffmann, Udo; Brady, Thomas J.; Cury, Ricardo C.

In: American Journal of Roentgenology, Vol. 191, No. 2, 2008, p. 432-438.

Research output: Contribution to journalArticle

Dodd, JD, Rieber, J, Pomerantsev, E, Chaithiraphan, V, Achenbach, S, Moreiras, JM, Abbara, S, Hoffmann, U, Brady, TJ & Cury, RC 2008, 'Quantification of nonculprit coronary lesions: Comparison of cardiac 64-MDCT and invasive coronary angiography', American Journal of Roentgenology, vol. 191, no. 2, pp. 432-438. https://doi.org/10.2214/AJR.07.3315
Dodd, Jonathan D. ; Rieber, Johannes ; Pomerantsev, Eugene ; Chaithiraphan, Vithaya ; Achenbach, Stephan ; Moreiras, Javier M. ; Abbara, Suhny ; Hoffmann, Udo ; Brady, Thomas J. ; Cury, Ricardo C. / Quantification of nonculprit coronary lesions : Comparison of cardiac 64-MDCT and invasive coronary angiography. In: American Journal of Roentgenology. 2008 ; Vol. 191, No. 2. pp. 432-438.
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abstract = "OBJECTIVE. The purpose of our study was to evaluate the accuracy of cardiac 64-MDCT to quantify the grade of stenosis of nonculprit lesions. SUBJECTS AND METHODS. Twenty-nine consecutive patients (23 men and six women; mean age, 62 ± 10 years) presenting with acute coronary syndrome (ACS) had nonculprit coronary lesions of ≥ 30{\%} stenosis quantified on quantitative coronary angiography (QCA). Five 64-MDCT postprocessing techniques (maximum intensity projection [MIP], multiplanar reformat [MPR], cross-sectional area [CSA], and diameter and area derived from semiquantitative coronary software) were used to grade lesions. Two separate groups of two independent readers analyzed QCA and cardiac CT images using a 17-segment model. Coronary angiography was the reference standard. RESULTS. Nonculprit lesions were identified in 46 analyzable coronary segments. Subgrouping lesions on the basis of reference vessel diameter resulted in strong correlations for quantifying nonculprit lesions in vessels > 3 mm (R = 0.78-0.91, p < 0.01) but poor correlations for nonculprit lesions in vessels ≤ 3 mm (R = 0.1-0.07). Subgrouping lesions on the basis of plaque type resulted in poor correlations for calcified plaques (R = 0.01-0.30) but moderate to strong correlations for mixed (R = 0.58-0.75, p < 0.01) and noncalcified (R = 0.44-0.61, p < 0.01) plaques. The best overall correlation among all CT techniques with QCA was CSA (R = 0.56, p < 0.01). Interobserver agreement (kappa values) for MPR, MIP, coronary software diameter and area were 0.6, 0.7, 0.62, and 0.57, respectively. CONCLUSION. In patients presenting with ACS, 64-MDCT provided an accurate grade of stenosis for nonculprit coronary lesions in proximal coronary segments. Calcified plaques and lesions in coronary segments ≤ 3 mm diameter remained difficult to accurately quantify.",
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T1 - Quantification of nonculprit coronary lesions

T2 - Comparison of cardiac 64-MDCT and invasive coronary angiography

AU - Dodd, Jonathan D.

AU - Rieber, Johannes

AU - Pomerantsev, Eugene

AU - Chaithiraphan, Vithaya

AU - Achenbach, Stephan

AU - Moreiras, Javier M.

AU - Abbara, Suhny

AU - Hoffmann, Udo

AU - Brady, Thomas J.

AU - Cury, Ricardo C.

PY - 2008

Y1 - 2008

N2 - OBJECTIVE. The purpose of our study was to evaluate the accuracy of cardiac 64-MDCT to quantify the grade of stenosis of nonculprit lesions. SUBJECTS AND METHODS. Twenty-nine consecutive patients (23 men and six women; mean age, 62 ± 10 years) presenting with acute coronary syndrome (ACS) had nonculprit coronary lesions of ≥ 30% stenosis quantified on quantitative coronary angiography (QCA). Five 64-MDCT postprocessing techniques (maximum intensity projection [MIP], multiplanar reformat [MPR], cross-sectional area [CSA], and diameter and area derived from semiquantitative coronary software) were used to grade lesions. Two separate groups of two independent readers analyzed QCA and cardiac CT images using a 17-segment model. Coronary angiography was the reference standard. RESULTS. Nonculprit lesions were identified in 46 analyzable coronary segments. Subgrouping lesions on the basis of reference vessel diameter resulted in strong correlations for quantifying nonculprit lesions in vessels > 3 mm (R = 0.78-0.91, p < 0.01) but poor correlations for nonculprit lesions in vessels ≤ 3 mm (R = 0.1-0.07). Subgrouping lesions on the basis of plaque type resulted in poor correlations for calcified plaques (R = 0.01-0.30) but moderate to strong correlations for mixed (R = 0.58-0.75, p < 0.01) and noncalcified (R = 0.44-0.61, p < 0.01) plaques. The best overall correlation among all CT techniques with QCA was CSA (R = 0.56, p < 0.01). Interobserver agreement (kappa values) for MPR, MIP, coronary software diameter and area were 0.6, 0.7, 0.62, and 0.57, respectively. CONCLUSION. In patients presenting with ACS, 64-MDCT provided an accurate grade of stenosis for nonculprit coronary lesions in proximal coronary segments. Calcified plaques and lesions in coronary segments ≤ 3 mm diameter remained difficult to accurately quantify.

AB - OBJECTIVE. The purpose of our study was to evaluate the accuracy of cardiac 64-MDCT to quantify the grade of stenosis of nonculprit lesions. SUBJECTS AND METHODS. Twenty-nine consecutive patients (23 men and six women; mean age, 62 ± 10 years) presenting with acute coronary syndrome (ACS) had nonculprit coronary lesions of ≥ 30% stenosis quantified on quantitative coronary angiography (QCA). Five 64-MDCT postprocessing techniques (maximum intensity projection [MIP], multiplanar reformat [MPR], cross-sectional area [CSA], and diameter and area derived from semiquantitative coronary software) were used to grade lesions. Two separate groups of two independent readers analyzed QCA and cardiac CT images using a 17-segment model. Coronary angiography was the reference standard. RESULTS. Nonculprit lesions were identified in 46 analyzable coronary segments. Subgrouping lesions on the basis of reference vessel diameter resulted in strong correlations for quantifying nonculprit lesions in vessels > 3 mm (R = 0.78-0.91, p < 0.01) but poor correlations for nonculprit lesions in vessels ≤ 3 mm (R = 0.1-0.07). Subgrouping lesions on the basis of plaque type resulted in poor correlations for calcified plaques (R = 0.01-0.30) but moderate to strong correlations for mixed (R = 0.58-0.75, p < 0.01) and noncalcified (R = 0.44-0.61, p < 0.01) plaques. The best overall correlation among all CT techniques with QCA was CSA (R = 0.56, p < 0.01). Interobserver agreement (kappa values) for MPR, MIP, coronary software diameter and area were 0.6, 0.7, 0.62, and 0.57, respectively. CONCLUSION. In patients presenting with ACS, 64-MDCT provided an accurate grade of stenosis for nonculprit coronary lesions in proximal coronary segments. Calcified plaques and lesions in coronary segments ≤ 3 mm diameter remained difficult to accurately quantify.

KW - Coronary angiography

KW - Coronary stenosis

KW - CT

KW - Myocardial infarction

KW - Nonculprit coronary lesion

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