冠状动脉 CT 血管造影定量冠状动脉斑块分析的内-间读者可重复性。
Intra- and inter-reader reproducibility in quantitative coronary plaque analysis on coronary computed tomography angiography.
机构信息
Cardiovascular Imaging Section, Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
出版信息
Curr Probl Cardiol. 2024 Jul;49(7):102585. doi: 10.1016/j.cpcardiol.2024.102585. Epub 2024 Apr 28.
PURPOSE
Coronary artery plaque burden, low attenuation non-calcified plaque (LAP), and pericoronary adipose tissue (PCAT) on coronary CT angiography (CCTA), have been linked to future cardiac events. The purpose of this study was to evaluate intra- and inter reader reproducibility in the quantification of coronary plaque burden and its characteristics using an artificial intelligence-enhanced semi-automated software.
MATERIALS AND METHODS
A total of 10 women and 6 men, aged 52 (IQR 49-58) underwent CCTA using a Siemens Somatom Force, Somatom Definition AS and Somatom Definition Flash scanners. Two expert readers utilized dedicated semi-automatic software (vascuCAP, Elucid Bioimaging, Wenham, MA) to assess calcified plaque, low attenuation plaque and PCAT. Readers were blinded to all clinical information and repeated their analysis at 6 weeks in random order to minimize recall bias. Data analysis was performed on the right and left coronary arteries. Intra- and inter-reader reproducibility was compared using Pearson correlation coefficient, while absolute values between analyses and readers were compared with paired non-parametric tests. This is a sub-study of the Specialized Center of Research Excellence (SCORE) clinical trial (5U54AG062334).
RESULTS
A total of 64 vessels from 16 patients were analyzed. Intra-reader Pearson correlation coefficients for calcified plaque volume, LAP volume and PCAT volumes were 0.96, 0.99 and 0.92 for reader 1 and 0.94, 0.94 and 0.95 for reader 2, respectively, (all p < 0.0001). Inter-reader Pearson correlation coefficients for calcified plaque volume, LAP and PCAT volumes were 0.92, 0.96 and 0.78, and 0.99, 0.99 and 0.93 on the second analyses, all had a p value <0.0001. There was no significant bias on the corresponding Bland-Altman analyses.
CONCLUSION
Volume measurement of coronary plaque burden and PCAT volume can be performed with high intra- and inter-reader agreement.
目的
冠状动脉斑块负荷、低衰减非钙化斑块（LAP）和冠状动脉 CT 血管造影（CCTA）中的冠状脂肪组织（PCAT）与未来的心脏事件有关。本研究的目的是使用人工智能增强的半自动软件评估冠状动脉斑块负荷及其特征的定量分析的读者内和读者间可重复性。
材料与方法
共纳入 10 名女性和 6 名男性，年龄 52 岁（IQR 49-58），使用西门子 Somatom Force、Somatom Definition AS 和 Somatom Definition Flash 扫描仪进行 CCTA。两名专家读者使用专用半自动软件（vascuCAP，Elucid Bioimaging，Wenham，MA）评估钙化斑块、低衰减斑块和 PCAT。读者对所有临床信息均不知情，并以随机顺序在 6 周时重复分析，以尽量减少回忆偏倚。数据在右冠状动脉和左冠状动脉上进行分析。使用 Pearson 相关系数比较读者内和读者间的可重复性，而分析和读者之间的绝对值则使用配对非参数检验进行比较。这是 Specialized Center of Research Excellence（SCORE）临床试验（5U54AG062334）的子研究。
结果
共分析了 16 名患者的 64 支血管。对于钙化斑块体积、LAP 体积和 PCAT 体积，读者 1 的读者内 Pearson 相关系数分别为 0.96、0.99 和 0.92，读者 2 分别为 0.94、0.94 和 0.95（均 p <0.0001）。钙化斑块体积、LAP 和 PCAT 体积的读者间 Pearson 相关系数分别为 0.92、0.96 和 0.78，以及 0.99、0.99 和 0.93，第二次分析时所有 p 值均<0.0001。相应的 Bland-Altman 分析中没有显著偏差。
结论
冠状动脉斑块负荷和 PCAT 体积的体积测量具有较高的读者内和读者间一致性。
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