Abstract
BackgroundPrimary to validate a commercial semi-automated computed tomography angiography (CTA) –software for vulnerable plaque detection compared to histology of carotid endarterectomy (CEA) specimens and secondary validating calcifications scores by in vivo CTA with ex vivo non-contrast enhanced computed tomography (NCCT).MethodsFrom January 2014 to October 2016 53 patients were included retrospectively, using a cross-sectional design. All patients underwent both CTA and CEA. Sixteen patients had their CEA specimen NCCT scanned. The semi-automated CTA software analyzed carotid stenosis using different HU values defining plaque components. The predictive values of CTA based detection of vulnerable plaques were calculated. Quantification of calcifications on CTA using region of interest (ROI)-function and mathematical equations was done manually, and validated by NCCT of the CEA specimen.ResultsThe semi-automated CTA software had a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 89.1% (95% CI, 73.6% - 96.4%), 31.3% (95% CI, 12.1% - 58.5%), 75% (95% CI, 59.3% - 86.2%) and 55.6% (95% CI, 22.6% - 84.6%). Strong correlation between in vivo CTA and ex vivo NCCT in quantification of calcification was observed, but CTA systematically underestimated calcificationsscore (CALS) with increasing calcification.ConclusionThe CTA-software cannot be used in risk assessment of patients, due to poor specificity and NPV. The correlation between in vivo CTA and ex vivo NCCT was strong, proposing it to be used in both scientifically and clinical settings, but studies with larger sample sizes are needed.
Highlights
Primary to validate a commercial semi-automated computed tomography angiography (CTA) –software for vulnerable plaque detection compared to histology of carotid endarterectomy (CEA) specimens and secondary validating calcifications scores by in vivo CTA with ex vivo non-contrast enhanced computed tomography (NCCT)
The patient population was stratified into two groups, an intraplaque haemorrage (IPH)-containing group consisting of 37 patients (69.81%) with a mean (SD) age of 70.19 (±9.58) and a non IPH-containing group consisting of 16 patients (30.19%) with a mean (SD) age of 70.13 (±7.32)
Accuracy of the semi-automated CTA-software The efficiency of the semi-automated CTA-software was compared with carotid plaques, with and without IPH as the golden standard
Summary
Primary to validate a commercial semi-automated computed tomography angiography (CTA) –software for vulnerable plaque detection compared to histology of carotid endarterectomy (CEA) specimens and secondary validating calcifications scores by in vivo CTA with ex vivo non-contrast enhanced computed tomography (NCCT). Cerebral stroke is a well-known cause of mortality and morbidity primarily affecting the lives of the elderly population worldwide [1]. Stenosis of the carotid artery presents one of the major sources to cerebral stroke. Duplex ultrasound and Computed Tomographic Angiography (CTA) is used pre-operatively, to evaluate the degree of carotid stenosis (CS) and combined with cerebral symptomology to decide whether the carotid endarterectomy (CEA) is beneficial or not. The risk of stroke or mortality within 30 days. In addition CTA software’s have been developed to detect vulnerable plaques with high risk of recurrent cerebral attacks. The evidence of the usefulness in these methods are conflicting but still commercial available softwares are offered without proven validity [5, 6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
