Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Current Cardiovascular Imaging Reports
Published in: Current Cardiovascular Imaging Reports 8/2015

01-08-2015 | Cardiac Computed Tomography (TC Villines, Section Editor)

Noncalcified Plaque in Cardiac CT: Quantification and Clinical Implications

Authors: Micheala M. Hell, Stephan Achenbach, Prediman K. Shah, Daniel S. Berman, Damini Dey

Published in: Current Cardiovascular Imaging Reports | Issue 8/2015

Login to get access

Abstract

Coronary computed tomography angiography (CTA) is being increasingly used for direct, noninvasive evaluation of the coronary arteries. Beyond stenosis, coronary CTA also permits assessment of atherosclerotic plaque (including total and noncalcified plaque burden) and coronary artery remodeling, previously only measurable through invasive techniques. It has been shown that coronary plaque volume for noncalcified and mixed plaques and the arterial remodeling index correlate closely with corresponding measures from invasive intravascular ultrasound. Several studies have also shown a strong relationship between adverse plaque features imaged by coronary CTA and acute coronary syndrome, major adverse cardiovascular events, and ischemia. The aim of this review is to summarize current methods for quantitative measurement of atherosclerotic plaque features from coronary CTA and to discuss the clinical implications of noncalcified plaque as detected by CTA and reported in the current literature.
Literature
1.
Miller JM, Rochitte CE, Dewey M, et al. Diagnostic performance of coronary angiography by 64-Row CT. N Engl J Med. 2008;359:2324–36.PubMedCrossRef
2.
Meijboom WB, van Mieghem CAG, Mollet NR, et al. 64-slice computed tomography coronary angiography in patients with high, intermediate, or low pretest probability of significant coronary artery disease. J Am Coll Cardiol. 2007;50:1469–75.PubMedCrossRef
3.
Budoff MJ, Dowe D, Jollis JG, et al. Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY (assessment by coronary computed tomographic angiography of individuals undergoing invasive coronary angiography) trial. J Am Coll Cardiol. 2008;52:1724–32.PubMedCrossRef
4.
5.
Narula J, Garg P, Achenbach S, Motoyama S, Virmani R, Strauss HW. Arithmetic of vulnerable plaques for noninvasive imaging. Nat Clin Pract Cardiovasc Med. 2008;5 Suppl 2:S2–S10.PubMedCrossRef
6.
Maurovich-Horvat P, Ferencik M, Voros S, Merkely B, Hoffmann U. Comprehensive plaque assessment by coronary CT angiography. Nat Rev Cardiol. 2014;11:390–402.PubMedCrossRef
7.
Leber AW, Becker A, Knez A, et al. Accuracy of 64-slice computed tomography to classify and quantify plaque volumes in the proximal coronary system: a comparative study using intravascular ultrasound. J Am Coll Cardiol. 2006;47:672–7.PubMedCrossRef
8.
Petranovic M, Soni A, Bezzera H, et al. Assessment of nonstenotic coronary lesions by 64-slice multidetector computed tomography in comparison to intravascular ultrasound: evaluation of nonculprit coronary lesions. J Cardiovasc Comput Tomogr. 2009;3:24–31.PubMedCrossRef
9.
Schepis T, Marwan M, Pflederer T, et al. Quantification of noncalcified coronary atherosclerotic plaques with dual source computed tomography: comparison to intravascular ultrasound. Heart. 2010;96:610–5.PubMedCrossRef
10.
Achenbach S, Moselewski F, Ropers D, et al. Detection of calcified and noncalcified coronary atherosclerotic plaque by contrast-enhanced, submillimeter multidetector spiral computed tomography: a segment-based comparison with intravascular ultrasound. Circulation. 2004;109:14–7.PubMedCrossRef
11.
Cheng V, Nakazato R, Dey D, Gurudevan S, Tabak J, Budoff MJ, et al. Reproducibility of coronary artery plaque volume and composition quantification by 64-detector row coronary computed tomographic angiography: an intraobserver, interobserver, and interscan variability study. J Cardiovasc Comput Tomogr. 2009;3:312–20.PubMedCrossRef
12.•
Schmid M, Achenbach S, Ropers D, et al. Assessment of changes in non-calcified atherosclerotic plaque volume in the left main and left anterior descending coronary arteries over time by 64-slice computed tomography. Am J Cardiol. 2008;101:579–84. This study was one of the first to show that noncalcified plaque volumes manually quantified from CTA increased significantly over time and that CTA may be a tool to study the progression of atherosclerosis.PubMedCrossRef
13.
Achenbach S, Ropers D, Hoffmann U, et al. Assessment of coronary remodeling in stenotic and nonstenotic coronary atherosclerotic lesions by multidetector spiral computed tomography. J Am Coll Cardiol. 2004;43:842–7.PubMedCrossRef
14.•
Dey D, Schepis T, Marwan M, Slomka PJ, Berman DS, Achenbach S. Automated three-dimensional quantification of non-calcified coronary plaque from coronary CT angiography: comparison with Intravascular Ultrasound. Radiology. 2010;257:516–22. This study showed that automated standardized quantification of noncalcified plaque shows strong agreement and no significant differences with intravascular ultrasound.
15.
Marwan M, Pflederer T, Schepis T, et al. Coronary vessel and luminal area measurement using dual-source computed tomography in comparison with intravascular ultrasound: effect of window settings on measurement accuracy. J Comput Assist Tomogr. 2011;35:113–8.PubMedCrossRef
16.
Sarwar A, Rieber J, Mooyaart EA, et al. Calcified plaque: measurement of area at thin-section flat-panel CT and 64-section multidetector CT and comparison with histopathologic findings. Radiology. 2008;249:301–6.PubMedCrossRef
17.
Dey D, Slomka P, Chien D, et al. Direct quantitative in vivo comparison of calcified atherosclerotic plaque on vascular MRI and CT by multimodality image registration. J Magn Reson Imaging. 2006;23:345–54.PubMedCrossRef
18.
Cademartiri F, Mollet NR, Runza G, et al. Influence of intracoronary attenuation on coronary plaque measurements using multislice computed tomography: observations in an ex vivo model of coronary computed tomography angiography. Eur Radiol. 2005;15:1426–31.PubMedCrossRef
19.
Halliburton SS, Schoenhagen P, Nair A, et al. Contrast enhancement of coronary atherosclerotic plaque: a high-resolution, multidetector-row computed tomography study of pressure-perfused, human ex-vivo coronary arteries. Coron Artery Dis. 2006;17:553–60.PubMedCrossRef
20.
Maffei E, Martini C, Arcadi T, et al. Plaque imaging with CT coronary angiography: effect of intra-vascular attenuation on plaque type classification. World J Radiol. 2012;4:265–72.PubMedCentralPubMedCrossRef
21.
Cademartiri F, La Grutta L, Runza G, et al. Influence of convolution filtering on coronary plaque attenuation values: observations in an ex vivo model of multislice computed tomography coronary angiography. Eur Radiol. 2007;17:1842–9.PubMedCentralPubMedCrossRef
22.
Achenbach S, Boehmer K, Pflederer T, et al. Influence of slice thickness and reconstruction kernel on the computed tomographic attenuation of coronary atherosclerotic plaque. J Cardiovasc Comput Tomogr. 2010;4:110–5.PubMedCrossRef
23.
Dalager MG, Bottcher M, Andersen G, et al. Impact of luminal density on plaque classification by CT coronary angiography. Int J Cardiovasc Imaging. 2011;27:593–600.PubMedCrossRef
24.
Dey D, Cheng VY, Slomka PJ, Nakazato R, Ramesh A, Gurudevan S, et al. Automated three-dimensional quantification of non-calcified and calcified coronary plaque from coronary CT angiography. J Cardiovasc Comput Tomogr. 2009;3:372–82.PubMedCrossRef
25.
Brodoefel H, Burgstahler C, Heuschmid M, et al. Accuracy of dual-source CT in the characterisation of non-calcified plaque: use of a colour-coded analysis compared with virtual histology intravascular ultrasound. Br J Radiol. 2009;82:805–12.PubMedCentralPubMedCrossRef
26.
Brodoefel H, Burgstahler C, Sabir A, et al. Coronary plaque quantification by voxel analysis: dual-source MDCT angiography versus intravascular sonography. AJR Am J Roentgenol. 2009;192:W84–9.PubMedCentralPubMedCrossRef
27.
Otsuka M, Bruining N, Van Pelt NC, et al. Quantification of coronary plaque by 64-slice computed tomography: a comparison with quantitative intracoronary ultrasound. Investig Radiol. 2008;43:314–21.CrossRef
28.
Boogers MJ, Broersen A, van Velzen JE, et al. Automated quantification of coronary plaque with computed tomography: comparison with intravascular ultrasound using a dedicated registration algorithm for fusion-based quantification. Eur Heart J. 2012;33:1007–16.PubMedCrossRef
29.
Schuhback A, Marwan M, Gauss S, et al. Interobserver agreement for the detection of atherosclerotic plaque in coronary CT angiography: comparison of two low-dose image acquisition protocols with standard retrospectively ECG-gated reconstruction. Eur Radiol. 2012;22:1529–36.PubMedCrossRef
30.•
Schuhbaeck A, Dey D, Otaki Y, et al. Interscan reproducibility of quantitative coronary plaque volume and composition from CT coronary angiography using an automated method. Eur Radiol. 2014;24:2300–8. This study revealed a high interscan reproducibility of coronary atherosclerostic plaques for automated quantification.PubMedCrossRef
31.•
Marwan M, Taher MA, El Meniawy K, et al. In vivo CT detection of lipid-rich coronary artery atherosclerotic plaques using quantitative histogram analysis: a head to head comparison with IVUS. Atherosclerosis. 2011;215:110–5. This study compared CT-based assessment of the composition of non-calcified plaques with IVUS presenting lower CT attenuation of lipid-rich compared to fibrous plaques.PubMedCrossRef
32.
Pundziute G, Schuijf JD, Jukema JW, et al. Head-to-head comparison of coronary plaque evaluation between multislice computed tomography and intravascular ultrasound radiofrequency data analysis. J Am Coll Cardiol Intv. 2008;1:176–82.CrossRef
33.
Rinehart S, Vazquez G, Qian Z, Murrieta L, Christian K, Voros S. Quantitative measurements of coronary arterial stenosis, plaque geometry, and composition are highly reproducible with a standardized coronary arterial computed tomographic approach in high-quality CT datasets. J Cardiovasc Comput Tomogr. 2011;5:35–43.PubMedCrossRef
34.
Motoyama S, Kondo T, Sarai M, et al. Multislice computed tomographic characteristics of coronary lesions in acute coronary syndromes. J Am Coll Cardiol. 2007;50:319–26.PubMedCrossRef
35.••
Motoyama S, Sarai M, Harigaya H, et al. Computed tomographic angiography characteristics of atherosclerotic plaques subsequently resulting in acute coronary syndrome. J Am Coll Cardiol. 2009;54:49–57. This study of 1059 patients showed that patients with positively remodeled and low attenuation coronary plaques were at a higher risk of future acute coronary syndrome.PubMedCrossRef
36.
Pflederer T, Marwan M, Schepis T, Ropers D, Seltmann M, Muschiol G, et al. Characterization of culprit lesions in acute coronary syndromes using coronary dual-source CT angiography. Atherosclerosis. 2010;211:437–44.PubMedCrossRef
37.
Ehara S, Kobayashi Y, Yoshiyama M, et al. Spotty calcification typifies the culprit plaque in patients with acute myocardial infarction: an intravascular ultrasound study. Circulation. 2004;110:3424–9.PubMedCrossRef
38.
van der Hoeven BL, Liem SS, Oemrawsingh PV, et al. Role of calcified spots detected by intravascular ultrasound in patients with ST-segment elevation acute myocardial infarction. Am J Cardiol. 2006;98:309–13.PubMedCrossRef
39.
Maurovich-Horvat P, Hoffmann U, Vorpahl M, Nakano M, Virmani R, Alkadhi H. The napkin-ring sign: CT signature of high-risk coronary plaques? J Am Coll Cardiol Img. 2010;3:440–4.CrossRef
40.
Narula J, Achenbach S. Napkin-ring necrotic cores: defining circumferential extent of necrotic cores in unstable plaques. J Am Coll Cardiol Img. 2009;2:1436–8.CrossRef
41.
Hoffmann U, Moselewski F, Nieman K, et al. Noninvasive assessment of plaque morphology and composition in culprit and stable lesions in acute coronary syndrome and stable lesions in stable angina by multidetector computed tomography. J Am Coll Cardiol. 2006;47:1655–62.PubMedCrossRef
42.
Ferencik M, Schlett CL, Ghoshhajra BB, et al. A computed tomography-based coronary lesion score to predict acute coronary syndrome among patients with acute chest pain and significant coronary stenosis on coronary computed tomographic angiogram. Am J Cardiol. 2012;110:183–9.PubMedCentralPubMedCrossRef
43.
Seifarth H, Schlett CL, Nakano M, et al. Histopathological correlates of the napkin-ring sign plaque in coronary CT angiography. Atherosclerosis. 2012;224:90–6.PubMedCrossRef
44.
Nance JW, Schlett CL, Schoepf UJ, et al. Incremental prognostic value of different components of coronary atherosclerotic plaque at cardiac CT angiography beyond coronary calcification in patients with acute chest pain. Radiology. 2012;264:679–90.PubMedCrossRef
45.••
Puchner SB, Liu T, Mayrhofer T, et al. High-risk plaque detected on coronary CT angiography predicts acute coronary syndromes independent of significant stenosis in acute chest pain: results from the ROMICAT-II trial. J Am Coll Cardiol. 2014;64:684–92. This analysis from the ROMICAT-II trial showed that high-risk coronary plaque features improve identification of an ACS independently from the presence of significant stenosis and clinical risk assessment.PubMedCrossRef
46.
Dey D, Achenbach S, Schuhbaeck A et al. Comparison of quantitative atherosclerotic plaque burden from coronary CT angiography in patients with first acute coronary syndrome and stable coronary artery disease. J Cardiovasc Comput Tomogr. 2014:in press.
47.
Min JK, Shaw LJ, Devereux RB, et al. Prognostic value of multidetector coronary computed tomographic angiography for prediction of All-cause mortality. J Am Coll Cardiol. 2007;50:1161–70.PubMedCrossRef
48.
Pundziute G, Schuijf JD, Jukema JW, et al. Prognostic value of multislice computed tomography coronary angiography in patients with known or suspected coronary artery disease. J Am Coll Cardiol. 2007;49:62–70.PubMedCrossRef
49.
Gaemperli O, Valenta I, Schepis T, et al. Coronary 64-slice CT angiography predicts outcome in patients with known or suspected coronary artery disease. Eur Radiol. 2008;18:1162–73.PubMedCrossRef
50.
Hadamitzky M, Freissmuth B, Meyer T, et al. Prognostic value of coronary computed tomographic angiography for prediction of cardiac events in patients with suspected coronary artery disease. J Am Coll Cardiol Cardiovasc Imaging. 2009;2:404–11.CrossRef
51.
Carrigan TP, Nair D, Schoenhagen P, et al. Prognostic utility of 64-slice computed tomography in patients with suspected but no documented coronary artery disease. Eur Heart J. 2009;30:362–71.PubMedCrossRef
52.
Chow BJ, Wells GA, Chen L, et al. Prognostic value of 64-slice cardiac computed tomography severity of coronary artery disease, coronary atherosclerosis, and left ventricular ejection fraction. J Am Coll Cardiol. 2010;55:1017–28.PubMedCrossRef
53.
Goldstein JA, Chinnaiyan KM, Abidov A, et al. The CT-STAT (coronary computed tomographic angiography for systematic triage of acute chest pain patients to treatment) trial. J Am Coll Cardiol. 2011;58:1414–22.PubMedCrossRef
54.
Kristensen TS, Kofoed KF, Kuhl JT, Nielsen WB, Nielsen MB, Kelbaek H. Prognostic implications of nonobstructive coronary plaques in patients with non-ST-segment elevation myocardial infarction: a multidetector computed tomography study. J Am Coll Cardiol. 2011;58:502–9.PubMedCrossRef
55.
Russo V, Zavalloni A, Bacchi Reggiani ML, et al. Incremental prognostic value of coronary CT angiography in patients with suspected coronary artery disease. Circ Cardiovasc Imaging. 2010;3:351–9.PubMedCrossRef
56.
Min J, Feignoux J, Treutenaere J, Laperche T, Sablayrolles J. The prognostic value of multidetector coronary CT angiography for the prediction of major adverse cardiovascular events: a multicenter observational cohort study. Int J Cardiovasc Imaging. 2010;26:721–8.PubMedCrossRef
57.
Petretta M, Daniele S, Acampa W, et al. Prognostic value of coronary artery calcium score and coronary CT angiography in patients with intermediate risk of coronary artery disease. Int J Cardiovasc Imaging. 2012;28:1547–56.PubMedCrossRef
58.
Alexanderson E, Canseco-Leon N, Inarra F, Meave A, Dey D. Prognostic value of cardiovascular CT: is coronary artery calcium screening enough? The added value of CCTA. J Nucl Cardiol. 2012;19:601–8.PubMedCrossRef
59.
Mark DB, Berman DS, Budoff MJ, et al. ACCF/ACR/AHA/NASCI/SAIP/SCAI/SCCT 2010 expert consensus document on coronary computed tomographic angiographyA report of the american college of cardiology foundation task force on expert consensus documents. J Am Coll Cardiol. 2010;55:2663–99.PubMedCrossRef
60.
Otsuka K, Fukuda S, Tanaka A, et al. Napkin-ring sign on coronary CT angiography for the prediction of acute coronary syndrome. J Am Coll Cardiol Img. 2013;6:448–57.CrossRef
61.•
Versteylen MO, Kietselaer BL, Dagnelie PC et al. Additive value of semi-automated quantification of coronary artery disease using cardiac CT-angiography to predict for future acute coronary syndrome. Journal of the American College of Cardiology 2013; In press. This study investigated the prediction of a future ACS by coronary CTA showing a significant added value over Framingham Risk Score and conventional visual clinical assessment.
62.
Achenbach S, Berman DS, Budoff MJ, Callister TQ, Chang H, Cheng V, et al. Prognostic value of coronary CT angiography for the prediction of mortality and Non-fatal major adverse cardiac events: results from the multinational CONFIRM registry. Circulation. 2011;124:A14099. Abstract.
63.
Bamberg F, Sommer WH, Hoffmann V, et al. Meta-analysis and systematic review of the long-term predictive value of assessment of coronary atherosclerosis by contrast-enhanced coronary computed tomography angiography. J Am Coll Cardiol. 2011;57:2426–36.PubMedCrossRef
64.
Hulten EA, Carbonaro S, Petrillo SP, Mitchell JD, Villines TC. Prognostic value of cardiac computed tomography angiographyA systematic review and meta-analysis. J Am Coll Cardiol. 2011;57:1237–47.PubMedCrossRef
65.
Lin F, Shaw LJ, Berman DS, et al. Multidetector computed tomography coronary artery plaque predictors of stress-induced myocardial ischemia by SPECT. Atherosclerosis. 2008;197:700–9.PubMedCrossRef
66.
Bauer RW, Thilo C, Chiaramida SA, Vogl TJ, Costello P, Schoepf UJ. Noncalcified atherosclerotic plaque burden at coronary ct angiography: a better predictor of ischemia at stress myocardial perfusion imaging than calcium score and stenosis severity. Am J Roentgenol. 2009;193:410–8.CrossRef
67.
Shmilovich H, Cheng VY, Tamarappoo BK, et al. Vulnerable plaque features on coronary CT angiography as markers of inducible regional myocardial hypoperfusion from severe coronary artery stenoses. Atherosclerosis. 2011;219:588–95.PubMedCentralPubMedCrossRef
68.
Naya M, Murthy VL, Blankstein R, et al. Quantitative relationship between the extent and morphology of coronary atherosclerotic plaque and downstream myocardial perfusion. J Am Coll Cardiol. 2011;58:1807–16.PubMedCentralPubMedCrossRef
69.
Dey D, Diaz Zamudio M, Schuhbaeck A, Orozco LEJ, Otaki Y, Gransar HG, Li D, Germano G, Achenbach S, Berman DS, Meave A, Alexanderson E, Slomka PJ. Relationship between quantitative adverse plaque features from coronary CT angiography and downstream impaired myocardial flow reserve. American College of Cardiology Scientific Sessions 2015.
70.
Min JK, Leipsic J, Pencina MJ, Berman DS, Koo BK, Mieghem CV, et al. Diagnostic accuracy of fractional flow reserve from anatomic CT angiography. JAMA. 2012;308:1237–45.PubMedCentralPubMedCrossRef
71.
Koo BK, Erglis A, Doh JH, et al. Diagnosis of ischemia-causing coronary stenoses by noninvasive fractional flow reserve computed from coronary computed tomographic angiograms. Results from the prospective multicenter DISCOVER-FLOW (diagnosis of ischemia-causing stenoses obtained Via noninvasive fractional flow reserve) study. J Am Coll Cardiol. 2011;58:1989–97.PubMedCrossRef
72.•
Nørgaard BL, Leipsic J, Gaur S, et al. Diagnostic performance of noninvasive fractional flow reserve derived from coronary computed tomography angiography in suspected coronary artery diseaseThe NXT trial (analysis of coronary blood flow using CT angiography: next steps). J Am Coll Cardiol. 2014;63:1145–55. This multicenter trial study investigated CT-derived FFR, with invasive FFR as the reference standard, showing high diagnostic accuracy and discrimination for the diagnosis of hemodynamically significant coronary artery disease.
73.
Kristensen TS, Engstrom T, Kelbaek H, von der Recke P, Nielsen MB, Kofoed KF. Correlation between coronary computed tomographic angiography and fractional flow reserve. Int J Cardiol. 2009;144:200–5.PubMedCrossRef
74.
Nakazato R, Shalev A, Doh J-H, et al. Aggregate plaque volume by coronary computed tomography angiography is superior and incremental to luminal narrowing for diagnosis of ischemic lesions of intermediate stenosis severity. J Am Coll Cardiol. 2013;62:460–7.PubMedCrossRef
75.
Park HB, Heo R, o Hartaigh B, et al. Atherosclerotic plaque characteristics by CT angiography identify coronary lesions that cause ischemia: a direct comparison to fractional flow reserve. JACC Cardiovasc Imaging. 2015;8:1–10.PubMedCrossRef
76.
Wong DT, Ko BS, Cameron JD, et al. Transluminal attenuation gradient in coronary computed tomography angiography is a novel noninvasive approach to the identification of functionally significant coronary artery stenosis: a comparison with fractional flow reserve. J Am Coll Cardiol. 2013;61:1271–9.PubMedCrossRef
77.
Hell M.M. DD, Marwan M, Achenbach S, Schmid J, Schuhbaeck A. Non-invasive Prediction of Hemodynamically Significant Coronary Artery Stenoses by Contrast Density Difference in Coronary CT Angiography. European Journal of Radiology 2015:in press.
78.•
Diaz Zamudio M, Dey D, Schuhbaeck A, Nakazato R. Slomka PJ, Bermand DS, Achenbach S, Min JK, Doh JH, Koo BK. Automated quantitative plaque burden from coronary CT Angiography noninvasively predicts hemodynamic significance by fractional flow reserve in intermediate coronary lesions Radiology 2015:in press, epub available April 17, 2015. This study examined the performance of automated total, noncalcified and low-attenuation noncalcified plaque burden compared to measured stenosis showing an improvement of identification and discrimination of ischemic lesions of intermediate stenosis severity.
79.
Lehman SJ, Schlett CL, Bamberg F, et al. Assessment of coronary plaque progression in coronary computed tomography angiography using a semiquantitative score. J Am Coll Cardiol Img. 2009;2:1262–70.CrossRef
80.
Papadopoulou S-L, Neefjes LA, Garcia-Garcia HM, et al. Natural history of coronary atherosclerosis by multislice computed tomography. J Am Coll Cardiol Img. 2012;5:S28–37.CrossRef
81.
Hoffmann H, Frieler K, Schlattmann P, Hamm B, Dewey M. Influence of statin treatment on coronary atherosclerosis visualised using multidetector computed tomography. Eur Radiol. 2010;20:2824–33.PubMedCrossRef
82.
Inoue K, Motoyama S, Sarai M, et al. Serial coronary CT angiography verified changes in plaque characteristics as an end point evaluation of effect of statin intervention. J Am Coll Cardiol Img. 2010;3:691–8.CrossRef
83.
Kitagawa T, Yamamoto H, Horiguchi J, et al. Effects of statin therapy on non-calcified coronary plaque assessed by 64-slice computed tomography. Int J Cardiol. 2011;150:146–50.PubMedCrossRef
84.
Shimojima M, Kawashiri M, Nitta Y, Yoshida T, Katsuda S, Kaku B, et al. Rapid changes in plaque composition and morphology after intensive lipid lowering therapy: study with serial coronary CT angiography. Am J Cardiovasc Dis. 2012;2:84–8.PubMedCentralPubMed
85.
Zeb I, Li D, Nasir K, et al. Effect of statin treatment on coronary plaque progression: a serial coronary CT angiography study. Atherosclerosis. 2013;231:198–204.PubMedCrossRef
86.
Lo JLMT, Ihenachor EJ, Wei J, Looby SE, Fitch KV, Oh J, et al. Effects of statin therapy on coronary artery plaque volume and high-risk plaque morphology in HIV-infected patients with subclinical atherosclerosis: a randomised, double-blind, placebo-controlled trial. Lancet HIV. 2015;2:e52–63.CrossRef
87.•
Arbab-Zadeh A, Fuster V. The myth of the “vulnerable plaque”: transitioning from a focus on individual lesions to atherosclerotic disease burden for coronary artery disease risk assessment. J Am Coll Cardiol. 2015;65:846–55. This review addresses the impact of patient-based overall atherosclerotic disease burden versus individual plaque assessment for the prediction of adverse cardiovascular events.PubMedCrossRef
Metadata
Title
Noncalcified Plaque in Cardiac CT: Quantification and Clinical Implications
Authors
Micheala M. Hell
Stephan Achenbach
Prediman K. Shah
Daniel S. Berman
Damini Dey
Publication date
01-08-2015
Publisher
Springer US
Published in
Current Cardiovascular Imaging Reports / Issue 8/2015
Print ISSN: 1941-9066
Electronic ISSN: 1941-9074
DOI
https://doi.org/10.1007/s12410-015-9343-z

Other articles of this Issue 8/2015

Current Cardiovascular Imaging Reports 8/2015 Go to the issue

Cardiac Computed Tomography (TC Villines, Section Editor)

Cardiac CT vs. Stress Testing in Patients with Suspected Coronary Artery Disease: Review and Expert Recommendations

Cardiac Nuclear Imaging (A Cuocolo, Section Editor)

Is Attenuation Correction for Myocardial Perfusion Imaging Underutilized?

Intravascular Imaging (I.-K. Jang, Section Editor)

Translating Intravascular Optical Coherence Tomography from a Research to a Clinical Tool

Cardiac Magnetic Resonance (E Nagel and V Puntmann, Section Editors)

The Role of Cardiac MRI in Patients with Troponin-Positive Chest Pain and Unobstructed Coronary Arteries

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits