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Gao Y, Pan Y, Jia C. Influencing factors and improvement methods of coronary artery plaque evaluation in CT. Front Cardiovasc Med 2024; 11:1395350. [PMID: 38984352 PMCID: PMC11232181 DOI: 10.3389/fcvm.2024.1395350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 05/14/2024] [Indexed: 07/11/2024] Open
Abstract
Accurate evaluation of the nature and composition of coronary plaque involves clinical follow-up and prognosis. Coronary CT angiography is the most commonly non-invasive method for plaque evaluation, however, the qualitative and quantitative evaluation of plaque based on CT value is inaccurate, due to the influence of luminal attenuation, tube voltage, parameter setting and the subjectivity.
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Affiliation(s)
- Yaqi Gao
- Department of Cardiovascular Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yao Pan
- Department of Cardiovascular Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Chongfu Jia
- Department of Cardiovascular Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
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He Z, Luo J, Lv M, Li Q, Ke W, Niu X, Zhang Z. Characteristics and evaluation of atherosclerotic plaques: an overview of state-of-the-art techniques. Front Neurol 2023; 14:1159288. [PMID: 37900593 PMCID: PMC10603250 DOI: 10.3389/fneur.2023.1159288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 09/28/2023] [Indexed: 10/31/2023] Open
Abstract
Atherosclerosis is an important cause of cerebrovascular and cardiovascular disease (CVD). Lipid infiltration, inflammation, and altered vascular stress are the critical mechanisms that cause atherosclerotic plaque formation. The hallmarks of the progression of atherosclerosis include plaque ulceration, rupture, neovascularization, and intraplaque hemorrhage, all of which are closely associated with the occurrence of CVD. Assessing the severity of atherosclerosis and plaque vulnerability is crucial for the prevention and treatment of CVD. Integrating imaging techniques for evaluating the characteristics of atherosclerotic plaques with computer simulations yields insights into plaque inflammation levels, spatial morphology, and intravascular stress distribution, resulting in a more realistic and accurate estimation of plaque state. Here, we review the characteristics and advancing techniques used to analyze intracranial and extracranial atherosclerotic plaques to provide a comprehensive understanding of atheroma.
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Affiliation(s)
- Zhiwei He
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jiaying Luo
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Mengna Lv
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Qingwen Li
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Wei Ke
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xuan Niu
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhaohui Zhang
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
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Liu H, Wingert A, Wang J, Zhang J, Wang X, Sun J, Chen F, Khalid SG, Jiang J, Zheng D. Extraction of Coronary Atherosclerotic Plaques From Computed Tomography Imaging: A Review of Recent Methods. Front Cardiovasc Med 2021; 8:597568. [PMID: 33644127 PMCID: PMC7903898 DOI: 10.3389/fcvm.2021.597568] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 01/18/2021] [Indexed: 12/21/2022] Open
Abstract
Background: Atherosclerotic plaques are the major cause of coronary artery disease (CAD). Currently, computed tomography (CT) is the most commonly applied imaging technique in the diagnosis of CAD. However, the accurate extraction of coronary plaque geometry from CT images is still challenging. Summary of Review: In this review, we focused on the methods in recent studies on the CT-based coronary plaque extraction. According to the dimension of plaque extraction method, the studies were categorized into two-dimensional (2D) and three-dimensional (3D) ones. In each category, the studies were analyzed in terms of data, methods, and evaluation. We summarized the merits and limitations of current methods, as well as the future directions for efficient and accurate extraction of coronary plaques using CT imaging. Conclusion: The methodological innovations are important for more accurate CT-based assessment of coronary plaques in clinical applications. The large-scale studies, de-blooming algorithms, more standardized datasets, and more detailed classification of non-calcified plaques could improve the accuracy of coronary plaque extraction from CT images. More multidimensional geometric parameters can be derived from the 3D geometry of coronary plaques. Additionally, machine learning and automatic 3D reconstruction could improve the efficiency of coronary plaque extraction in future studies.
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Affiliation(s)
- Haipeng Liu
- Research Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom.,Faculty of Health, Education, Medicine, and Social Care, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Aleksandra Wingert
- Faculty of Health, Education, Medicine, and Social Care, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Jian'an Wang
- Department of Cardiology, School of Medicine, The Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Jucheng Zhang
- Department of Clinical Engineering, School of Medicine, The Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Xinhong Wang
- Department of Radiology, School of Medicine, The Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Jianzhong Sun
- Department of Radiology, School of Medicine, The Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Fei Chen
- Department of Electrical and Electronic Engineering, Southern University of Science and Technology, Shenzhen, China
| | - Syed Ghufran Khalid
- Research Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Jun Jiang
- Department of Cardiology, School of Medicine, The Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Dingchang Zheng
- Research Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
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Should CT replace IVUS for evaluation of CAD in large-scale clinical trials: Effects of medical therapy on atherosclerotic plaque. J Cardiovasc Comput Tomogr 2019; 13:248-253. [PMID: 31351840 DOI: 10.1016/j.jcct.2019.06.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 05/15/2019] [Accepted: 06/23/2019] [Indexed: 11/22/2022]
Abstract
Clinical trials assessing the effect of medical therapies on atherosclerotic plaques have hitherto employed invasive imaging techniques such as intravascular ultrasound (IVUS). This has limited the study population to high-risk patients in whom invasive coronary angiography is indicated; moreover, IVUS typically is performed utilizing a target lesion-based analysis. Recently, comprehensive quantitative analysis of all atherosclerotic plaques in the complete coronary artery network has become possible through the use of coronary computed tomography angiography (CCTA). Excellent inter-observer and inter-scan reproducibility of CCTA has been reported. Several studies have already tested the applicability of CCTA-measured plaque volume changes as an imaging surrogate endpoint in clinical trials and have found positive results. Further, substantial evidence supports the use of CCTA as a novel imaging surrogate that can accurately assess the changes in plaque characteristics according to medical treatment. In this review, we summarize current evidences that support the use of CCTA as a novel imaging surrogate that can replace IVUS in evaluating the results of treatment. We also attempt to determine whether the technological advances in CCTA will extend its application beyond use as a diagnostic method in clinical practice to use in large-scale clinical trials.
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