AUTHOR=Ran Qisheng , Chen Diyou , Zhang Huiru , Zhang Letian 

TITLE=When can coronary computed tomography angiography in patients with calcified plaque be accurate?

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2025.1570517

DOI=10.3389/fcvm.2025.1570517

ISSN=2297-055X

ABSTRACT=AimTo identify a new method to indicate when coronary computed tomography angiography (CCTA) in patients with calcified plaque can be accurate.MethodsProspective 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.ResultsThe 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%.ConclusionOur study suggests that the accuracy of detection of stenosis with CCTA in calcified vessels is related to the difference in Hu values between calcified plaques and blood.