Non-invasive characterization of coronary artery atherosclerotic plaque using dual energy CT: Explanation in ex-vivo samples |
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| Institution: | 1. Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA;2. Deparment of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA;3. Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI, USA;4. Department of Cardiac Imaging, King Abdul Aziz Cardiac Center, Riyadh, Saudi Arabia;5. Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD, USA;6. Department of Epidemiology and Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA;7. Department of Medicine, Division of Cardiology, Department of Radiology, Johns Hopkins University, Baltimore, MD, USA;8. Department of Internal Medicine, Section on Cardiology, Wake Forest School of Medicine, Winston-Salem, NC, USA;9. Epidemiological Cardiology Research Center (EPICARE), Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA;1. Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands;2. Department of Biomolecular Chemistry, NCMLS, Nijmegen University, The Netherlands;3. Department of Cardiovascular Medicine, University of Muenster, Muenster, Germany;4. Cells-in-Motion Cluster of Excellence (EXC 1003 — CiM), University of Münster, Münster, Germany;1. Division of Cardiology, Departmet of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea;2. Brain Korea 21 Project for Medical Science Yonsei University, Republic of Korea;3. Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Seoul, South Korea;4. Department of Internal Medicine, Yonsei University Gangnam Severance Hospital, Seoul, Republic of Korea;5. Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 250 Seongsanno, Seodaemungu, Seoul 120-752, Republic of Korea;1. Department of Central Radiology, Kumamoto University Hospital, Chuo-ku, Kumamoto, Japan;2. Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan;3. Department of Medical Physics, Faculty of Life Sciences, Kumamoto University, Chuo-ku, Kumamoto, Japan;4. Department of Cardiovascular Medicine, Faculty of Life Sciences, Kumamoto University, Chuo-ku, Kumamoto, Japan |
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| Abstract: | PurposeIn this study non-calcified plaque composition is evaluated by Dual Energy CT (DECT). Energy Dispersive X-ray Spectroscopy (EDS) has been used to study the Plaque composition. An attempt has been made to explain the DECT results with EDS analysis.MethodsThirty-two ex-vivo human cadaver coronary artery samples were scanned by DECT and data was evaluated to calculate their effective atomic number and electron density (Zeff & ρe) by inversion method. Result of DECT was compared with pathology to assess their differentiating capability. The EDS study was used to explain DECT outcome.ResultsDECT study was able to differentiate vulnerable plaque from stable with 87% accuracy (area under the curve (AUC):0.85 95% confidence interval {CI}:0.73–0.98}] and Kappa Coefficient (KC):0.75 with respect to pathology. EDS revealed significant compositional difference in vulnerable and stable plaque at p < .05. The weight percentage of higher atomic number elements like F, Na, Mg, S, Si, P, Cl, K and Ca was found to be slightly more in vulnerable plaques as compared to a stable plaque. EDS also revealed a significantly increased weight percentage of nitrogen in stable plaques.ConclusionsThe EDS results were able to explain the outcomes of DECT study. This study conclusively explains the physics of DECT as a tool to assess the nature of non-calcified plaques as vulnerable and stable. The method proposed in this study allows for differentiation between vulnerable and stable plaque using DECT. |
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| Keywords: | Non-invasive Dual energy CT Atherosclerosis Compositional analysis |
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