ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Cardiovascular Imaging
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1570517
This article is part of the Research TopicBiomechanics and Mechanotransduction in Cardiovascular CalcificationView all 4 articles
When can coronary computed tomography angiography in patients with calcified plaque be accurate?
Provisionally accepted
- 1Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China
- 2Department of Gastroenterology, Daping Hospital, Chongqing, China
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Aim: To identify a new method to indicate when coronary computed tomography angiography (CCTA) in patients with calcified plaque can be accurate. Methods: Prospective analysis on 105 cases of coronary artery stenosis with calcified plaque underwent both CCTA and invasive coronary angiography (ICA). The Hounsfield unit (Hu) values of calcified plaque and adjacent blood were measured, and then the ratio (RHu) was subsequently calculated. The ICA data served as the gold standard for defining obstructive stenosis (≥ 50%) and were utilized to create a two-dimensional receiver operating characteristic (ROC) curve. The cut-off value was employed to categorize the CCTA data. Additionally, a Bland-Altman plot was used to analyze discrepancies in stenosis degree detection between CCTA and ICA. An in vitro experiment was designed to assess the practicability of RHu. Results: The RHu was correlated with the concordance of CCTA and ICA for stenosis evaluation (r = 0.509, p < 0.001). ROC analysis suggested a cut-off value of 0.36. The Bland-Altman plot indicated that stenosis evaluation by CCTA demonstrates good concordance when RHu exceeds 0.36; however, significant bias occurs when RHu is below 0.36 in comparison to ICA. In vitro experiments confirmed that the RHu parameter can be easily adjusted to enhance the accuracy of CCTA. In validation experiments, the RHu achieved a prediction accuracy of 74.0%. Conclusion: Our study suggests that the accuracy of detection of stenosis with CCTA in calcified vessels can be incrementally improved by reducing the Hu values difference between calcified plaques and blood.
Keywords: computed tomography angiography, Digital subtraction angiography, Vascular Calcification, Coronary Artery Disease, Coronary Stenosis
Received: 03 Feb 2025; Accepted: 03 Sep 2025.
Copyright: © 2025 Ran, Chen, Zhang and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Huiru Zhang, Department of Gastroenterology, Daping Hospital, Chongqing, 400042, China
Letian Zhang, Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China
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