1 Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, Ashley River Tower, Charleston, SC 29425.
AJR Am J Roentgenol. 2014 Jan;202(1):W43-9. doi: 10.2214/AJR.13.11225.
The objective of our study was to evaluate the reproducibility of noncalcified coronary artery plaque burden quantification from coronary CT angiography (CTA) across different commercial analysis platforms.
For this study, 47 patients (36 men, 11 women; mean age ± SD, 62 ± 13 years) with noncalcified plaques on coronary CTA were included. Automated quantification of noncalcified coronary artery plaque volume was performed on identical datasets using three commercially available image analysis software platforms (software platforms 1-3). Identical tissue attenuation ranges between 0 and 50 HU for low-attenuation plaques and 50-130 HU for medium-attenuation plaques were consistently applied. Log volume data were compared with the Pearson correlation coefficient and Bland-Altman analysis.
Differences in plaque volume measurements on intraplatform repeat measurements were statistically insignificant (p = 0.923). At the low-attenuation threshold, software platform 3 had significantly higher log volumes (p < 0.001) than both software platforms 1 and 2 and software platform 1 had significantly higher log volumes than software platform 2 (p < 0.001). The results at the medium-attenuation level were identical except that the log volumes for software platforms 1 and 2 were not significantly different (p > 0.05) in the left anterior descending artery and left circumflex artery. The Pearson correlation coefficient was found to be 0.677 (p < 0.001; 95% CI, 0.608-0.735) between software platforms 1 and 2, 0.672 (p < 0.001; 95% CI, 0.603-0.732) between software platforms 1 and 3, and 0.550 (p < 0.001; 95% CI, 0.463-0.627) between software platforms 2 and 3.
Currently available noncalcified plaque quantification software provides good intraplatform reproducibility but poor interplatform reproducibility. Serial or comparative assessments require evaluation using the same software. Industry standards should be developed to enable reproducible assessments across manufacturers.
本研究旨在评估不同商业分析平台从冠状动脉 CT 血管造影（CTA）定量非钙化冠状动脉斑块负担的可重复性。
这项研究纳入了 47 名患者（36 名男性，11 名女性；平均年龄 ± 标准差，62 ± 13 岁），他们的冠状动脉 CTA 上有非钙化斑块。使用三种商业上可用的图像分析软件平台（软件平台 1-3），在相同的数据集上自动定量非钙化冠状动脉斑块体积。一致地应用相同的组织衰减范围，即低衰减斑块为 0 至 50HU，中衰减斑块为 50 至 130HU。对数体积数据用 Pearson 相关系数和 Bland-Altman 分析进行比较。
平台内重复测量的斑块体积测量值差异无统计学意义（p = 0.923）。在低衰减阈值下，软件平台 3 的对数体积显著高于软件平台 1 和 2（p < 0.001），软件平台 1 的对数体积也显著高于软件平台 2（p < 0.001）。在中衰减水平的结果相同，只是软件平台 1 和 2 的左前降支和左回旋支之间的对数体积没有显著差异（p > 0.05）。Pearson 相关系数为软件平台 1 和 2 之间的 0.677（p < 0.001；95%CI，0.608-0.735），软件平台 1 和 3 之间的 0.672（p < 0.001；95%CI，0.603-0.732），软件平台 2 和 3 之间的 0.550（p < 0.001；95%CI，0.463-0.627）。
目前可用的非钙化斑块定量软件提供了良好的平台内可重复性，但平台间的可重复性较差。需要使用相同的软件进行连续或比较评估。应制定行业标准，以实现跨制造商的可重复评估。
