How early can atherosclerosis be detected by coronary CT angiography? Insights from quantitative CT analysis of serial scans in the PARADIGM trial.

Cardoso, Rhanderson; Choi, Andrew D; Shiyovich, Arthur; Besser, Stephanie A; Min, James K; Earls, James; Andreini, Daniele; Al-Mallah, Mouaz H; Budoff, Matthew J; Cademartiri, Filippo; Chinnaiyan, Kavitha; Choi, Jung Hyun; Chun, Eun Ju; Conte, Edoardo; Gottlieb, Ilan; Hadamitzky, Martin; Kim, Yong-Jin; Lee, Byoung Kwon; Leipsic, Jonathon A; Maffei, Erica; Marques, Hugo; de Araújo Gonçalves, Pedro; Pontone, Gianluca; Lee, Sang-Eun; Sung, Ji Min; Virmani, Renu; Samady, Habib; Lin, Fay Y; Stone, Peter H; Berman, Daniel S; Narula, Jagat; Shaw, Leslee J; Bax, Jeroen J; Chang, Hyuk-Jae; Blankstein, Ron

Cardoso, Rhanderson; Choi, Andrew D; Shiyovich, Arthur; Besser, Stephanie A; Min, James K; Earls, James; Andreini, Daniele; Al-Mallah, Mouaz H; Budoff, Matthew J; Cademartiri, Filippo; Chinnaiyan, Kavitha; Choi, Jung Hyun; Chun, Eun Ju; Conte, Edoardo; Gottlieb, Ilan; Hadamitzky, Martin; Kim, Yong-Jin; Lee, Byoung Kwon; Leipsic, Jonathon A; Maffei, Erica; Marques, Hugo; de Araújo Gonçalves, Pedro; Pontone, Gianluca; Lee, Sang-Eun; Sung, Ji Min; Virmani, Renu; Samady, Habib; Lin, Fay Y; Stone, Peter H; Berman, Daniel S; Narula, Jagat; Shaw, Leslee J; Bax, Jeroen J; Chang, Hyuk-Jae; Blankstein, Ron.

Affiliation

Cardoso R; Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: rcardoso2@bwh.harvard.edu.
Choi AD; Department of Cardiology, The George Washington University School of Medicine, Washington, DC, USA.
Shiyovich A; Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Besser SA; Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Min JK; Cleerly Inc, New York, NY, USA.
Earls J; Cleerly Inc, New York, NY, USA.
Andreini D; Division of Cardiology and Cardiac Imaging, IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy; Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
Al-Mallah MH; Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX, USA.
Budoff MJ; Department of Medicine, Lundquist Institute at Harbor-UCLA, Torrance, CA, USA.
Cademartiri F; Fondazione Monasterio/CNR, Pisa, Italy.
Chinnaiyan K; Department of Cardiology, William Beaumont Hospital, Royal Oak, MI, USA.
Choi JH; Busan University Hospital, Busan, South Korea.
Chun EJ; Seoul National University Bundang Hospital, Sungnam, South Korea.
Conte E; Centro Cardiologico Monzino, IRCCS, Milan, Italy.
Gottlieb I; Department of Radiology, Casa de Saude Sao Jose, Rio de Janeiro, Brazil.
Hadamitzky M; Department of Radiology and Nuclear Medicine, German Heart Center Munich, Munich, Germany.
Kim YJ; Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea.
Lee BK; Gangnam Severance Hospital, Younsei University College of Medicine, Seoul, South Korea.
Leipsic JA; Department of Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, Canada.
Maffei E; IRCCS SYNLAB SDN, Naples, Italy.
Marques H; Hospital da Luz, Lisbon, Portugal.
de Araújo Gonçalves P; Hospital da Luz, Lisbon, Portugal.
Pontone G; Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy; Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.
Lee SE; Division of Cardiology, Department of Internal Medicine, Ewha Womans University, Seoul, South Korea.
Sung JM; CONNECT-AI Research Center, Yonsei University College of Medicine, Seoul, South Korea.
Virmani R; Department of Pathology, CVPath Institute, Gaithersburg, MD, USA.
Samady H; Georgia Heart Institute, Northeast Georgia Health System, Gainesville, GA, USA.
Lin FY; Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Stone PH; Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Berman DS; Department of Imaging, Cedars-Sinai Medical Center, Cedars-Sinai Heart Institute, Los Angeles, CA, USA.
Narula J; University of Texas Health Houston, Houston, TX, USA.
Shaw LJ; Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Bax JJ; Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Leiden, the Netherlands.
Chang HJ; CONNECT-AI Research Center, Yonsei University College of Medicine, Seoul, South Korea; Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea.
Blankstein R; Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

J Cardiovasc Comput Tomogr ; 17(6): 407-412, 2023.

Article in En | MEDLINE | ID: mdl-37798157

ABSTRACT

ABSTRACT

BACKGROUND:

Non-obstructing small coronary plaques may not be well recognized by expert readers during coronary computed tomography angiography (CCTA) evaluation. Recent developments in atherosclerosis imaging quantitative computed tomography (AI-QCT) enabled by machine learning allow for whole-heart coronary phenotyping of atherosclerosis, but its diagnostic role for detection of small plaques on CCTA is unknown.

METHODS:

We performed AI-QCT in patients who underwent serial CCTA in the multinational PARADIGM study. AI-QCT results were verified by a level III experienced reader, who was blinded to baseline and follow-up status of CCTA. This retrospective analysis aimed to characterize small plaques on baseline CCTA and evaluate their serial changes on follow-up imaging. Small plaques were defined as a total plaque volume <50 âmm3.

RESULTS:

A total of 99 patients with 502 small plaques were included. The median total plaque volume was 6.8 âmm3 (IQR 3.5-13.9 âmm3), most of which was non-calcified (median 6.2 âmm3; 2.9-12.3 âmm3). The median age at the time of baseline CCTA was 61 years old and 63% were male. The mean interscan period was 3.8 â± â1.6 years. On follow-up CCTA, 437 (87%) plaques were present at the same location as small plaques on baseline CCTA; 72% were larger and 15% decreased in volume. The median total plaque volume and non-calcified plaque volume increased to 18.9 âmm3 (IQR 8.3-45.2 âmm3) and 13.8 âmm3 (IQR 5.7-33.4 âmm3), respectively, among plaques that persisted on follow-up CCTA. Small plaques no longer visualized on follow-up CCTA were significantly more likely to be of lower volume, shorter in length, non-calcified, and more distal in the coronary artery, as compared with plaques that persisted at follow-up.

CONCLUSION:

In this retrospective analysis from the PARADIGM study, small plaques (<50 âmm3) identified by AI-QCT persisted at the same location and were often larger on follow-up CCTA.

Subject(s)

Atherosclerosis; Coronary Artery Disease; Plaque, Atherosclerotic; Humans; Male; Middle Aged; Female; Computed Tomography Angiography/methods; Retrospective Studies; Predictive Value of Tests; Coronary Angiography/methods; Tomography, X-Ray Computed/methods; Coronary Artery Disease/diagnostic imaging

Key words

Artificial intelligence; Atherosclerosis; Coronary; Coronary CT angiography; Small plaque

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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Coronary Artery Disease / Atherosclerosis / Plaque, Atherosclerotic Limits: Female / Humans / Male / Middle aged Language: En Journal: J Cardiovasc Comput Tomogr Journal subject: ANGIOLOGIA / CARDIOLOGIA / RADIOLOGIA Year: 2023 Type: Article

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