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Harvard researchers present a reliable noninvasive approach for measuring coronary plaque progression with CT in a paper appearing in the November 2009 issue of the Journal of the American College of Cardiology: Cardiovascular Imaging.

The 69-patient study by Dr Sam Lehman and colleagues found a significant increase (12.7%, p=0.01) in coronary plaque burden among patients with acute chest pain but not acute coronary syndrome with a "highly reproducible" semiquantitative assessment of coronary plaque burden measured as the average number of CT cross-section images containing plaque.

Although the feasibility of measuring plaque volume by CT has been evaluated before, those studies found substantial interobserver variability for the assessment of plaque volume, the authors explain. The technique described by Lehman et al had a 0.2% interobserver variability, which is low enough to accurately assess the change in plaque burden over time, the authors state.

Lehman et al performed baseline and two-year follow-up CT angiography in 69 patients originally enrolled in the Rule Out Myocardial Infarction Using Computer Assisted Tomography (ROMICAT) trial, previously reported by heartwire. Atherosclerotic plaque burden at both baseline and follow-up was assessed for the entire left main coronary tree and the proximal 40 mm of the left anterior descending, left circumflex, and right coronary arteries.

Images deemed to be of sufficient quality by two experienced observers were read by an experienced reader blinded to the time of the scan to determine the presence of calcified or noncalcified plaque. Interobserver and intraobserver variability for plaque detection was assessed in 15 randomly selected subjects by two blinded observers.

Source: theheart.org

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