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Measuring Noncalcified Coronary Atherosclerotic Plaque Using Voxel Analysis with MDCT Angiography: A Pilot Clinical Study

¹ Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave., WCC-302, Boston, MA 02215.
² Department of Cardiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA.

OBJECTIVE. The purpose of our study was to evaluate a new method using voxel analysis for quantifying noncalcified plaque in coronary arteries using MDCT angiography (MDCTA) compared with luminal stenosis by catheter coronary arteriography.

MATERIALS AND METHODS. Forty-one normal and eight abnormal arterial cross sections with noncalcified plaque selected from 40 patients undergoing MDCTA were analyzed for percentage of stenosis and plaque volume using a voxel analysis technique.

RESULTS. Using voxel analysis, the normal arterial wall thickness was determined to be 0.8 ± 0.4 mm. Attenuation values (in Hounsfield units) for normal segments ranged between 30 and 175 H and for abnormal (plaque-containing) segments ranged from -49 to 139 H (p < 0.05). Plaque volume measurements varied from 0.90 to 156 mm³ with good interobserver correlation (R² = 0.9671). Percentage of stenosis correlated with quantitative coronary arteriography measurement (R² = 0.55). Voxel analysis underestimated the percentage of stenosis (Pearson's correlation coefficient, 1.2; p = 0.03).

CONCLUSION. The study shows that the voxel analysis technique appears to be an accurate and reproducible method to measure arterial wall thickness, noncalcified plaque, and degree of arterial stenosis using density values measured in Hounsfield units. The technique may be useful on further correlative studies.

Keywords: cardiac imaging • coronary artery wall • coronary imaging • CT angiography • MDCT • micro-CT • voxel analysis

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				H. Brodoefel, C. Burgstahler, A. Sabir, C.-S. Yam, F. Khosa, C. D. Claussen, and M. E. Clouse Coronary Plaque Quantification by Voxel Analysis: Dual-Source MDCT Angiography Versus Intravascular Sonography Am. J. Roentgenol., March 1, 2009; 192(3): W84 - W89. [Abstract] [Full Text] [PDF]