Optimal boundary detection method and window settings for coronary atherosclerotic plaque volume analysis in coronary...

Area of Science:

• Cardiovascular imaging
• Medical diagnostics
• Radiology

Background:

• Quantitative plaque volume analysis by coronary CT angiography (QCT) is an emerging technique.
• Accurate plaque volume measurement is crucial for assessing cardiovascular disease.
• Standardization of QCT methodology is needed for reliable plaque quantification.

Purpose of the Study:

• To determine the optimal methodology for quantitative plaque volume analysis using coronary CT angiography (QCT).
• To compare different boundary detection methods and window width/level settings for QCT plaque volume assessment.
• To validate QCT findings against intravascular ultrasound (IVUS) measurements.

Main Methods:

• Fifty-one coronary artery segments were analyzed using QCT.
• Two boundary detection methods were compared: no gap and a fixed 0.3-mm gap.
• Three window width and level (WW/WL) settings were evaluated: fixed (740/220 HU), segment-adjusted, and aorta-adjusted.

Main Results:

• The fixed 0.3-mm gap method showed no significant difference compared to IVUS for plaque volume (139.8 ± 93.9 mm³ vs. 136.1 ± 72.8 mm³).
• The 'no gap' method significantly underestimated plaque volume compared to IVUS (105.4 ± 82.3 mm³ vs. 136.1 ± 72.8 mm³).
• The fixed HU setting (740/220) demonstrated the least mean difference in plaque volume compared to IVUS (3.8 ± 39.8 mm³).

Conclusions:

• Optimal quantitative plaque volume assessment using QCT is achieved with a fixed 0.3-mm gap for boundary detection.
• The fixed Hounsfield unit (HU) setting of 740/220 provides the most accurate plaque volume measurements.
• This standardized QCT approach enhances the reliability of plaque quantification in coronary artery disease.