Quantitative Assessment of Coronary Plaques by Coronary CT Angiography: High Inter-Reader and Intra-Reader Agreement is Achieved but Inter-Scanner Variability should not be Ignored.
Coronary CT angiography (CCTA) is currently a widely used imaging modality for the diagnostic assessment of patients with suspected coronary artery disease (CAD) with high diagnostic accuracy reported in the literature.1-5 Rapid technological developments on cardiac CT imaging have occurred over the last decade which have led to the development and improvement of diagnostic spectrum of CCTA in the quantitative analysis of coronary plaques, in addition to the diagnostic value of coronary artery stenosis. These included characterization of plaque features and the corresponding clinical outcomes such as prediction of major adverse cardiac events, in addition to the routine assessment of coronary lumen stenosis.
There are three observations from Symons’ study that bear discussions. First, the authors have demonstrated the accuracy and reliability of CCTA in the quantitative assessment of plaque volume. This finding is consistent with the current literature which supports the increasing use of CCTA for coronary plaque imaging analysis. Of different plaque features, low-attenuation area or
non-calcified plaque represents one of the reliable indicators to determine plaque vulnerability and predict major adverse cardiac events. Therefore, assessment of non-calcified plaque in terms of total plaque volume has significant clinical value.
The second comment is related to the variability of multislice CT scanner with regard to the plaque volume measurement. The two CT scanners used in this study included Toshiba 320-and Siemens Force scanners. The 320-slice scanner enables longitudinal coverage of 16 cm, although the temporal resolution (137.5 ms) is not as good as that of dual-source CT scanners.
Heart Res Open J. 2017; 4(1): e1-e5. doi: 10.17140/HROJ-4-e007
