Artificial intelligence-powered automatic coronary computed tomography angiography plaque quantification: comparison against optical coherence tomography

作者：Guanyu Li, Wei Yu, Zhiqing Wang, Yankai Chen, Miao Chu, Zehang Li, Chunming Li, Xiaoling Wang, Yuanming Yan, Yukun Luo, Wei Cai, Giovanni Luigi De Maria, Charalambos Antoniades, Adrian Banning, L L Chen, Shengxian Tu · 发表于：European Heart Journal - Digital Health · 年份：2026 · DOI：10.1093/ehjdh/ztag024 · 被引用次数：2 · 研究领域：Coronary Interventions and Diagnostics、Optical Coherence Tomography Applications、Retinal Diseases and Treatments

Abstract Aims Coronary computed tomography angiography (CCTA) enables a non-invasive, comprehensive assessment of coronary artery disease, and artificial intelligence (AI) offers the potential to improve CCTA image interpretation. This study aimed to evaluate the performance of an AI-powered method for automatic plaque quantification from CCTA, with optical coherence tomography (OCT) as reference standard. Methods and results Patients who underwent CCTA within 6 months prior to OCT were retrospectively enrolled. AI-assisted automatic plaque quantification was performed on CCTA with specific plaque composition classification based on adaptive Hounsfield unit thresholds. Qualitative high-risk plaque features were also assessed. Automated co-registration of CCTA and OCT was performed with the link of invasive coronary angiography. A total of 91 patients with 153 co-registered lesions were evaluated. The AI-assisted automatic CCTA analysis showed significant correlations with OCT for quantifying plaque volume/burden and different plaque compositions (all P values <0.001); of which, the correlation coefficient for plaque volume was 0.84. Vulnerable plaque, defined as lipid-to-cap ratio >0.33 on OCT, was identified in 39 (25.5%) lesions. CCTA-derived plaque volume >82.5 mm3 [odds ratio (OR), 9.39], maximal plaque burden >76.4% (OR, 3.70), lipidic tissue volume >16.3 mm³ (OR, 4.42), all P < 0.001, and high-risk plaque features ≥2 (OR, 2.70, ...