Shane Oberoi BS, Presenter: Nothing to Disclose

Christian Thilo MD, Abstract Co-Author: Speakers Bureau, Novartis AG, Munich, Germany

U. Joseph Schoepf MD, Abstract Co-Author: Speakers Bureau, Bracco Group Speakers Bureau, General Electric Company Speakers Bureau, Bayer AG Speakers Bureau, Siemens AG Medical Advisory Board, Siemens AG Medical Advisory Board, Bayer AG Research grant, Bayer AG Research grant, Bracco Group Research grant, General Electric Company Research grant, Siemens AG

There is increased interest in using coronary CT angiography (cCTA) for the assessment of the non-calcified coronary artery plaque burden for risk stratification and for monitoring the success of medical therapy. Especially the latter requires sufficient reproducibility to enable meaningful serial assessment. We aimed at determining the reproducibility of non-calcified plaque burden quantification across different commercial image analysis platforms.

Forty-seven patients with documented non-calcified plaques on cCTA were included. Automated quantification of non-calcified coronary artery plaque burden was performed on the identical data sets using three different commercially available image analysis platforms (Aquarius, TeraRecon; Circulation, Siemens; Vitrea, Vital). In each patient the non-calcified plaque burden within the three major coronary arteries (left anterior descending-LAD, left circumflex-LCX, and right coronary artery-RCA) was quantified with each of the three software programs. Identical tissue attenuation ranges between 0 and 50HU for low and 50 to 130HU for medium attenuation plaque were consistently applied across workstations. Measurements were performed in duplicate to ensure reproducibility.

Mean values for low attenuation plaque for LAD, RCA, and LCX were 75.14, 47.67, and 51.88HU, respectively for Circulation, 75.89, 79.36, and 79.85HU for Aquarius, and 185.1, 200.3, and 139.4HU for Vitrea. Similarly, for medium attenuation plaque: 174.9, 109.9, and 136.1HU for Circulation, 129.4, 134.3, and 150.2HU for Aquarius, and 424.9, 493.4, and 391.9HU for Vitrea. For low attenuation plaque, the log (volumes) overall as well as for each coronary artery were significantly different (p<0.05) among the three softwares. The results for medium attenuation plaques were similar, except that Circulation and Aquarius were not significantly different in the LAD and LCX. Results between duplicate measurements were not significantly different (p>0.05) indicating reproducibility within the same software platform.

Currently available software platforms do not allow reproducible quantification of the non-calcified coronary artery plaque burden across different workstations. If serial assessment is desired, the identical system should be used.

Industry standards should be developed to enable reproducible non-calcified plaque burden assessment across manufacturers.

Oberoi, S, Thilo, C, Schoepf, U, Reproducibility of Noncalcified Coronary Artery Plaque Burden Assessment across Different Image Analysis Platforms.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9001962.html