Implications of computed tomography reconstruction algorithms on coronary atheroma composition: A head-to-head comparison with multimodality near-infrared spectroscopy intravascular ultrasound imaging

作者：Nathan Angelo Lecaros Yap, Xingwei He, İbrahi̇m Hali̇l Tanboğa, Anantharaman Ramasamy, S. Kyriakou, Pieter Kitslaar, Alexander Broersen, Johan H. C. Reiber, Jouke Dijkstra, Amear Mohammed, Mick Ozkor, Patrick W. Serruys, James Moon, Anthony Mathur, Andreas Baumbach, Ryo Torii, Francesca Pugliese, Christos V. Bourantas · 发表于：Journal of cardiovascular computed tomography · 年份：2025 · DOI：10.1016/j.jcct.2025.10.009 · 被引用次数：2 · 研究领域：Coronary Interventions and Diagnostics、Cardiac Imaging and Diagnostics、Cerebrovascular and Carotid Artery Diseases

BACKGROUND: To evaluate the performance of various computed tomography angiography (CTA) reconstruction methods in assessing coronary plaque composition using near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) as the reference standard. MATERIALS AND METHODS: Fifteen patients with chronic coronary syndrome underwent CTA and 3-vessel NIRS-IVUS imaging. CTA datasets were reconstructed using a medium-smooth b40f kernel with two slice thicknesses, 0.75 mm and 0.50 mm, and three strengths of advanced model-based iterative reconstruction (ADMIRE). Plaque components on CTA were classified using fixed and adaptive Hounsfield unit (HU) thresholds while NIRS-IVUS classification employed a deep learning method validated against histology. Matched CTA and NIRS-IVUS images were analyzed to quantify fibrotic tissue (FT), necrotic core (NC), and calcific (Ca) volumes and areas at both segment- and lesion-level. The intraclass correlation coefficient (ICC) and Surface Under the Cumulative Ranking Curve (SUCRA) scores were used to determine the best-performing reconstruction approach. RESULTS: Fifty vessels were included in the final analysis. CTA showed weak correlation with NIRS-IVUS for FT (ICC <0.43), good correlation for Ca (ICC 0.42-0.83), and poor correlation for NC, except when using reconstruction approach ADMIRE 2, 0.50 mm slice thickness, and fixed HU cutoffs, which demonstrated moderate correlation for NC (segment-level ICC = 0.67; lesion-level ICC = 0.61). This appro...