Coronary CTA of plaque, stenosis showed improvement with semi-automated software

Ferencik M. Abstract #216.

The 5th Annual Scientific Meeting of the Society of Cardiovascular Computed Tomography

Semi-automated software improved interobserver agreement for coronary CTA of both stenosis and plaque volume, according to study results.

Researchers analyzed CTA data from participants (n=31) of the ROMICAT trial with at least one coronary stenosis >50%. They analyzed stenoses (n=39) and associated coronary plaques via semi-automated software (Vitrea Enterprise Suite; Vital Images) by two independent readers. The evaluated degrees of stenosis and plaque volumes were defined as low (<90 Hounsfield units), intermediate (91-150 Hounsfield units) and high (>150 Hounsfield units).

Researchers found that manually measured stenosis correlated between readers (mean difference, 4 ± 9%; R²=0.71). Semi-automated stenosis measurements led to an improved correlation (mean difference, 1 ± 8%; R²=0.85), although there was only a moderate correlation between manual and semi-automated measurements (mean difference, 8 ± 15%; R²=0.52). Plaque volume analysis showed notable correlation between readers (mean difference, 19 ± 44 mm³; R²=.83), as well as improvement with semi-automated software (mean difference, –11 ± 14 mm³; R²=.86).

Maros Ferencik, PhD, MD, of Massachusetts General Hospital, Boston, and researcher on the study, said the study limitations that he noted in his presentation were the small sample size, the inclusion of plaques only associated with >50% stenosis, the excellent image quality required for the plaque evaluation and the lack of a comparison to a gold standard (eg, IVUS).

“Semi-automated software improved interobserver agreement for coronary CTA evaluation of stenosis and plaque volume. However, there was difference between manual and semi-automated measurements,” Ferencik said. “Further improvements of semi-automated software will be necessary prior to the implementation in clinical trials.”

This idea has been around for several years but needed a boost in technology, like this one, to make it fast, automated and reproducible to make this feasible for clinical trials. Once validated and widely available, there should be a multicenter evaluation of outcomes and treatments in the groups with different plaque densities.

– Kim Allan Williams, MD
Cardiology Today Editorial Board

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