Quantification of calcium burden by coronary CT angiography compared to optical coherence tomography
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ORIGINAL PAPER
Quantification of calcium burden by coronary CT angiography compared to optical coherence tomography G. Monizzi1,2,3 · J. Sonck1,4 · S. Nagumo1,5 · D. Buytaert1 · L. Van Hoe6 · L. Grancini2 · A. L. Bartorelli2,3 · P. Vanhoenacker6 · P. Simons6 · O. Bladt6 · E. Wyffels1 · B. De Bruyne1 · D. Andreini2,3 · C. Collet1 Received: 11 February 2020 / Accepted: 3 April 2020 / Published online: 17 November 2020 © Springer Nature B.V. 2020
Abstract Coronary artery calcifications (CAC) are frequently observed in patients referred for coronary CT angiography (CTA). Calcification volume (in mm3) can accurately be assessed during catheterization by optical coherence tomography (OCT). The aim of the present study was to investigate the accuracy of CTA-derived assessment of calcification volume as compared with OCT. 66 calcified plaques (32 vessels) from 31 patients undergoing OCT-guided PCI with coronary CT acquired as a standard of care were included. Coronary CT and OCT images were matched using fiduciary points. Calcified plaques were reconstructed in three dimensions to calculate calcium volume. A Passing–Bablok regression analysis and the Bland–Altman method were used to assess the agreement between imaging modalities. Twenty-seven left anterior descending arteries and 5 right coronary arteries were analyzed. Median calcium volume by CTA and OCT were 18.23 m m3 [IQR 8.09, 36.48] and 3 10.03 mm [IQR 3.6, 22.88] respectively; the Passing–Bablok analysis showed a proportional without a systematic difference (Coefficient A 0.08, 95% CI − 1.37 to 1.21, Coefficient B 1.61, 95% CI 1.45 to 1.84) and the mean difference was 9.69 mm3 (LOA − 10.2 to 29.6 mm3). No differences were observed for minimal lumen area (Coefficient A 0.07, 95% CI − 0.46 to 0.15, Coefficient B 0.85, 95% CI 0.64 to 1.2). CTA volumetric calcium evaluation overestimates calcium volume by 60% compared to OCT. This may allow for an appropriate interpretation of calcific burden in the non-invasive setting. Even in presence of calcific plaques, a good agreement in the MLA assessment was found. Coronary CT may emerge as a tool to quantify calcium burden for invasive procedural planning. Keywords Calcium · Coronary CT · OCT · PCI
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10554-020-01839-z) contains supplementary material, which is available to authorized users. * C. Collet [email protected] 1
Cardiovascular Center Aalst, Onze-Lieve-Vrouw Hospital, Moorselbaan 164, 9300 Aalst, Belgium
2
Centro Cardiologico Monzino, IRCCS, Milan, Italy
3
Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
4
Department of Advanced Biomedical Sciences, University of Napels, Federico II, Napels, Italy
5
Division of Cardiology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Kanagawa 2278501, Japan
6
Radiology Department, OLV Ziekenhuis Aalst, Aalst, Oost‑Vlaanderen, Belgium
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