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BMC Medical Imaging
Published in: BMC Medical Imaging 1/2017

Open Access 01-12-2017 | Research article

Computed tomography scan based prediction of the vulnerable carotid plaque

Authors: Hadi Mahmoud Haider Diab, Lars Melholt Rasmussen, Stevo Duvnjak, Axel Diederichsen, Pia Søndergaard Jensen, Jes Sanddal Lindholt

Published in: BMC Medical Imaging | Issue 1/2017

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Abstract

Background

Primary to validate a commercial semi-automated computed tomography angiography (CTA) –software for vulnerable plaque detection compared to histology of carotid endarterectomy (CEA) specimens and secondary validating calcifications scores by in vivo CTA with ex vivo non-contrast enhanced computed tomography (NCCT).

Methods

From January 2014 to October 2016 53 patients were included retrospectively, using a cross-sectional design. All patients underwent both CTA and CEA. Sixteen patients had their CEA specimen NCCT scanned. The semi-automated CTA software analyzed carotid stenosis using different HU values defining plaque components. The predictive values of CTA based detection of vulnerable plaques were calculated. Quantification of calcifications on CTA using region of interest (ROI)-function and mathematical equations was done manually, and validated by NCCT of the CEA specimen.

Results

The semi-automated CTA software had a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 89.1% (95% CI, 73.6% - 96.4%), 31.3% (95% CI, 12.1% - 58.5%), 75% (95% CI, 59.3% - 86.2%) and 55.6% (95% CI, 22.6% - 84.6%). Strong correlation between in vivo CTA and ex vivo NCCT in quantification of calcification was observed, but CTA systematically underestimated calcificationsscore (CALS) with increasing calcification.

Conclusion

The CTA-software cannot be used in risk assessment of patients, due to poor specificity and NPV. The correlation between in vivo CTA and ex vivo NCCT was strong, proposing it to be used in both scientifically and clinical settings, but studies with larger sample sizes are needed.
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Metadata
Title
Computed tomography scan based prediction of the vulnerable carotid plaque
Authors
Hadi Mahmoud Haider Diab
Lars Melholt Rasmussen
Stevo Duvnjak
Axel Diederichsen
Pia Søndergaard Jensen
Jes Sanddal Lindholt
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Medical Imaging / Issue 1/2017
Electronic ISSN: 1471-2342
DOI
https://doi.org/10.1186/s12880-017-0233-5

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