Compositional volumetry of non-calcified coronary plaques by multislice computed tomography: an ex vivo feasibility study

• Published in: EuroIntervention Vol. 5; no. 5; pp. 558 - 564
• Main Authors: BRUINING, Nico, ROELANDT, Jos R. T. C, HAMERS, Ronald, FEYTER, Pim J, VERHEYE, Stefan, KNAAPEN, Michiel, ONUMA, Yoshinobu, REGAR, Evelyn, CADEMARTIRI, Filippo, DE WINTER, Sebastiaan, VAN LANGENHOVE, Glenn, SERRUYS, Patrick W
• Format: Journal Article
• Language: English
• Published: Toulouse Société Europa Edition 01.11.2009
• Subjects: Autopsy; Azo Compounds; Biological and medical sciences; Calcium - analysis; Cardiology. Vascular system; Collagen - analysis; Contrast Media; Coronary Angiography - methods; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - metabolism; Coronary heart disease; Coronary Vessels - chemistry; Coronary Vessels - pathology; Eosine Yellowish-(YS); Feasibility Studies; Heart; Humans; Medical sciences; Methyl Green; Myocytes, Smooth Muscle - diagnostic imaging; Predictive Value of Tests; Radiographic Image Interpretation, Computer-Assisted; Staining and Labeling - methods; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tomography, Optical Coherence; Tomography, X-Ray Computed; coronary artery disease; Radiodiagnosis; Coronary artery; Cardiovascular disease; Histology; Coronary heart disease; Multislice computed tomography; Ex vivo; Volume; Medical imagery; Feasibility; Multislice; Computerized axial tomography
• ISSN: 1774-024X; 1969-6213
• DOI: 10.4244/EIJV5I5A91

Non-invasive quantitative compositional analysis of coronary plaque would be a major advantage to study coronary artery disease. This study explores the application to use the Hounsfield units (HU) distribution of coronary plaques imaged by multislice computed tomography-coronary angiography (MSCT-CA). A dedicated computer-assisted method was developed to measure the HU distribution within a coronary plaque by MSCT-CA. To test the feasibility of the method, an ex vivo left anterior descending (LAD) coronary specimen, excised during autopsy, was imaged both by non-enhanced and enhanced MSCT-CA. Quantitative histology was used as a reference. To test the feasibility of the new volumetric analytic method, the MSCT-CA data were compared with volumetric histopathology. The coronary specimen, with a heterogeneously distributed plaque composition without large areas of calcification, was histologically sampled at five different locations, 5 mm apart, where at each location 15 sections were taken at 100 microm intervals, resulting in 75 individual histology sections. Tri-chrome Masson staining was used for histology quantification of three plaque/tissue components: smooth muscle cells (SMC), collagen and calcium. MSCT plaque composition was defined as "lower-HU" or "higher-HU" plaque and "calcium" based on the HU distribution. Comparison of the MSCT defined tissue components against histology showed a good relationship without significant differences. This ex vivo study shows the feasibility of using the Hounsfield unit distribution to perform compositional coronary plaque volumetry by MSCT-CA. The results are encouraging.