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Updated: Aug 5, 2026
04:40
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Lesion-Level Association Between Artificial Intelligence-Derived Coronary Calcium Volume and Plaque Vulnerability
Ruben G A van der Waerden1, Joske L van der Zande1, Jan-Quinten Mol2
1Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands; Diagnostic Image Analysis Group, Radboud University Medical Center, Nijmegen, the Netherlands.
JACC. Advances
|July 28, 2026
Summary
Heavily calcified plaques show fewer vulnerability features, suggesting a lower risk of acute events. Less calcified, lipid-rich plaques exhibit more vulnerability indicators.
Area of Science:
- Cardiovascular research
- Interventional cardiology
- Medical imaging analysis
Background:
- Extensively calcified lesions are often associated with a lower risk of acute events.
- This reduced risk may stem from the presence of less vulnerable plaque characteristics.
Purpose of the Study:
- To investigate the relationship between total calcification volume and plaque vulnerability.
- To determine if calcification extent correlates with features indicative of plaque instability.
Main Methods:
- Prospective analysis of patients with myocardial infarction from the PECTUS-obs study.
- Intracoronary optical coherence tomography (OCT) imaging of nonculprit lesions.
- Analysis of plaque vulnerability features and automated calcium quantification using artificial intelligence (OCT-AID).
Main Results:
- Nearly all lesions (96.3%) showed calcification, with significant variation in total calcium volume across quartiles.
- Lower calcification quartiles (Q1-Q3) exhibited higher prevalence of lipid-rich plaques, macrophage accumulation, and microvessels.
- Higher calcification quartiles (Q4) had fewer plaque vulnerability features compared to lower quartiles (P < 0.001).
Conclusions:
- Severely calcified nonculprit lesions display a lower prevalence of vulnerability features.
- Less calcified, lipid-rich lesions present more vulnerability indicators.
- This finding supports the observation of lower acute event rates in heavily calcified lesions.
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