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Attenuation-based characterization of coronary atherosclerotic plaque: Comparison of dual source and dual energy CT with single-source CT and histopathology
Authors:Thomas Henzler  Stefan Porubsky  Hany Kayed  Nils Harder  U. Radko Krissak  Mathias Meyer  Tim Sueselbeck  Alexander Marx  Henrik Michaely  U. Joseph Schoepf  Stefan O. Schoenberg  Christian Fink
Affiliation:aDepartment of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim – Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany;bDepartment of Pathology, University Medical Center Mannheim, Medical Faculty Mannheim – Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany;c1st Department of Medicine University Medical Center Mannheim, Medical Faculty Mannheim – Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany;dDepartment of Radiology and Radiological Science, Medical University of South Carolina, 169 Ashley Avenue, Charleston, USA
Abstract:

Objective

To compare different CT acquisition techniques regarding for attenuation-based characterization of coronary atherosclerotic plaques using histopathology as the standard of reference.

Materials and methods

In a post mortem study 17 human hearts were studied with dual-source CT (DSCT) and dual energy CT (DECT) mode on a DSCT as well as with 16-slice single-source CT (SSCT). At autopsy, atherosclerotic lesions were cut at 5 μm sections. Histopathologic classification of the plaques according to the American Heart Association (AHA) criteria was performed by two pathologists. Attenuation values of all plaques were measured in DSCT, DECT and SSCT studies, respectively and classified based on attenuation according to modified AHA criteria.

Results

58 coronary plaques were identified at autopsy. Regardless of the CT technique only 52/58 plaques were found at CT (sensitivity = 89.6%). There was no significant difference between the mean attenuation values of different plaque types between DSCT, DECT, and SSCT: type IV: 11 HU/8 HU/19 HU; type Va: 44 HU/45 HU/52 HU; type Vb: 1088 HU/966 HU/1079 HU). The sensitivity for correct classification varied depending on the plaque type (type II = 0%, type III = 0%, type IV = 43%, type Va = 58%, Vb = 97%).

Conclusion

Independent of the used acquisition technique, SSCT, DSCT and DECT show similar results for attenuation-based characterization of atherosclerotic coronary plaques.
Keywords:Atherosclerotic plaque imaging   Histopathology   Dual-source computed tomography   Dual energy CT   Cross scatter radiation
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