Sebastian Winklhofer MD, Presenter: Nothing to Disclose

Peter Silvia, Abstract Co-Author: Nothing to Disclose

Verena Tischler MD, Abstract Co-Author: Nothing to Disclose

Fabian Morsbach, Abstract Co-Author: Nothing to Disclose

Moritz Werdt, von, Abstract Co-Author: Nothing to Disclose

Sandra Berens MD, Abstract Co-Author: Nothing to Disclose

Peter Modregger PhD, Abstract Co-Author: Nothing to Disclose

Holger Moch, Abstract Co-Author: Nothing to Disclose

Marco Stampanoni PhD, Abstract Co-Author: Nothing to Disclose

Michael J. Thali MD, Abstract Co-Author: Nothing to Disclose

Hatem Alkadhi MD, Abstract Co-Author: Nothing to Disclose

Paul Stolzmann MD, Abstract Co-Author: Nothing to Disclose

Purpose of the study was to investigate into X-ray grating interferometry phase-contrast (PC) imaging for the characterization of human coronary artery plaque.

PC X-ray and absorption computed tomography (CT) imaging was performed ex vivo in this institutional review board–approved study in forty human coronary artery segments using a synchrotron radiation source. Two independent readers performed qualitative analyses of image quality, plaque components, and plaque classification according to the modified American Heart Association (AHA) criteria in 38 plaques detected by histopathology, the latter serving as the reference standard. Quantitative measurements of plaque components (i.e., collagen, lipid, smooth muscle, and calcification) were performed and compared among PC and absorption images using analysis of variances (ANOVA) for repeated-measures with a post hoc Bonferroni correction.

Image quality was superior in PC images as compared with absorption imaging (P<0.001). Plaque components were detected by PC imaging without significant differences to histopathology, whereas absorption imaging detected calcifications without statistical differences only. Of the 38 detected coronary artery plaques, characterization was accurate in 33 plaques (87%) with PC; absorption imaging allowed for correct characterization of 7 plaques (13%, P<0.001). Hounsfield units (HU) of PC images were significantly different for all plaque components (pairwise P<0.05). Absorption images demonstrated significant differences (κ=0.81, P<0.001) between calcification and other plaque components, but were similar for collagen, lipid, and smooth muscle (P=1.00).

PC imaging allows for accurate characterization of human coronary artery plaque and quantitative assessment of plaque components, thereby outperforming absorption imaging.

Phase contrast imaging may not only allow for an improved understanding of the development of vulnerable plaque but for the identification of patients at risk for myocardial infarction.

Winklhofer, S, Silvia, P, Tischler, V, Morsbach, F, Werdt, von, M, Berens, S, Modregger, P, Moch, H, Stampanoni, M, Thali, M, Alkadhi, H, Stolzmann, P, Characteristics of Vulnerable Human Coronary Atherosclerotic Plaque: Phase-Contrast Imaging.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14001084.html