Three-dimensional reconstruction of coronary arteries and plaque morphology using CT angiography - comparison and registration using IVUS

Extraction of Coronary Atherosclerotic Plaques From Computed Tomography Imaging: A Review of Recent Methods

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.

The diagnostic value of three-dimensional CT angiography for patients with acute coronary artery disease

Computed tomography angiography (CTA) is an efficient method for the diagnosis of heart disease. However, few contemporary studies have evaluated the prognostic value of three-dimensional (3D)-CTA for patients with acute coronary artery disease. The aim of the present study was to investigate the diagnostic value of 3D-CTA for patients with acute coronary artery disease. A total of 136 patients with suspected acute coronary artery disease were recruited and received conventional coronary angiography (CCA) and 3D-CTA. 3D-CTA was used to assess calcified plaques in the coronary arteries (CCTA), the ratio of calcified plaque volume to vessel circumference (RVTC) and diagnostic accuracy. The results revealed that 3D-CTA was a more effective diagnostic method for identifying calcified plaques in patients with acute coronary artery disease compared with CCA. 3D-CTA demonstrated a significantly better area under curve, sensitivity, specificity, positive predictive value and negative predictive value compared with CCA (P<0.01). In the present study, 3D-CTA was used to successfully diagnose 86 patients with acute coronary artery disease, 34 with myocardial infarction and 16 with stable angina. 3D-CTA images clearly showed global noise levels and target-to-background ratios determined by manually delineated coronary plaque lesions compared with CCA. Furthermore, 3D-CTA was significantly better for discriminating ischemia compared with CCA (P<0.01). In conclusion, the results of the present study suggest that 3D-CTA provides superior diagnostic performance compared with CCA alone in patients with acute coronary artery disease.