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How early can atherosclerosis be detected by coronary CT angiography? Insights from quantitative CT analysis of serial scans in the PARADIGM trial

Authors
 Rhanderson Cardoso  ;  Andrew D Choi  ;  Arthur Shiyovich  ;  Stephanie A Besser  ;  James K Min  ;  James Earls  ;  Daniele Andreini  ;  Mouaz H Al-Mallah  ;  Matthew J Budoff  ;  Filippo Cademartiri  ;  Kavitha Chinnaiyan  ;  Jung Hyun Choi  ;  Eun Ju Chun  ;  Edoardo Conte  ;  Ilan Gottlieb  ;  Martin Hadamitzky  ;  Yong-Jin Kim  ;  Byoung Kwon Lee  ;  Jonathon A Leipsic  ;  Erica Maffei  ;  Hugo Marques  ;  Pedro de Araújo Gonçalves  ;  Gianluca Pontone  ;  Sang-Eun Lee  ;  Ji Min Sung  ;  Renu Virmani  ;  Habib Samady  ;  Fay Y Lin  ;  Peter H Stone  ;  Daniel S Berman  ;  Jagat Narula  ;  Leslee J Shaw  ;  Jeroen J Bax  ;  Hyuk-Jae Chang  ;  Ron Blankstein 
Citation
 JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY, Vol.17(6) : 407-412, 2023-11 
Journal Title
JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY
ISSN
 1934-5925 
Issue Date
2023-11
MeSH
Atherosclerosis* ; Computed Tomography Angiography / methods ; Coronary Angiography / methods ; Coronary Artery Disease* / diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Plaque, Atherosclerotic* ; Predictive Value of Tests ; Retrospective Studies ; Tomography, X-Ray Computed / methods
Keywords
Artificial intelligence ; Atherosclerosis ; Coronary ; Coronary CT angiography ; Small plaque
Abstract
Background: Non-obstructing small coronary plaques may not be well recognized by expert readers during coronary computed tomography angiography (CCTA) evaluation. Recent developments in atherosclerosis imaging quantitative computed tomography (AI-QCT) enabled by machine learning allow for whole-heart coronary phenotyping of atherosclerosis, but its diagnostic role for detection of small plaques on CCTA is unknown.



Methods: We performed AI-QCT in patients who underwent serial CCTA in the multinational PARADIGM study. AI-QCT results were verified by a level III experienced reader, who was blinded to baseline and follow-up status of CCTA. This retrospective analysis aimed to characterize small plaques on baseline CCTA and evaluate their serial changes on follow-up imaging. Small plaques were defined as a total plaque volume <50 ​mm3.



Results: A total of 99 patients with 502 small plaques were included. The median total plaque volume was 6.8 ​mm3 (IQR 3.5-13.9 ​mm3), most of which was non-calcified (median 6.2 ​mm3; 2.9-12.3 ​mm3). The median age at the time of baseline CCTA was 61 years old and 63% were male. The mean interscan period was 3.8 ​± ​1.6 years. On follow-up CCTA, 437 (87%) plaques were present at the same location as small plaques on baseline CCTA; 72% were larger and 15% decreased in volume. The median total plaque volume and non-calcified plaque volume increased to 18.9 ​mm3 (IQR 8.3-45.2 ​mm3) and 13.8 ​mm3 (IQR 5.7-33.4 ​mm3), respectively, among plaques that persisted on follow-up CCTA. Small plaques no longer visualized on follow-up CCTA were significantly more likely to be of lower volume, shorter in length, non-calcified, and more distal in the coronary artery, as compared with plaques that persisted at follow-up.
Files in This Item:
T202400916.pdf Download
DOI
10.1016/j.jcct.2023.08.012
Appears in Collections:
1. College of Medicine (의과대학) > Research Institute (부설연구소) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Sung, Ji Min(성지민)
Lee, Byoung Kwon(이병권) ORCID logo https://orcid.org/0000-0001-9259-2776
Chang, Hyuk-Jae(장혁재) ORCID logo https://orcid.org/0000-0002-6139-7545
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/198105
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