Flat-panel versus 64-channel computed tomography for in vivo quantitative characterization of aortic atherosclerotic plaques

Int J Cardiol. 2012 May 3;156(3):295-302. doi: 10.1016/j.ijcard.2010.11.011. Epub 2010 Dec 24.


Background: Flat-panel computed tomography (FpCT) provides better spatial resolution than 64-channel CT (64-CT) and may improve in vivo quantitative assessment of atherosclerotic plaques.

Methods and results: Lesions in 184 aortic histology sections from 6 Watanabe heritable hyperlipidemic rabbits were quantitatively compared with 64-CT (image thickness, 0.625 mm) and FpCT (image thickness, 0.150 mm) images. Images were re-oriented perpendicular to the vessel centerline. For detecting plaque, FpCT and 64-CT were not significantly different (sensitivity, 76% vs 66%; P=NS). Although FpCT was significantly more sensitive (42% vs 0%; P=<0.001) for detecting eccentric lesions, the area under the curve (AUC) for FpCT (0.6) was not significantly different from that for 64-CT (0.45; P=NS). In detecting plaques with ≤ 10% lipid (low attenuation foci), FpCT was significantly more sensitive than 64-CT (24% vs 0.7%; P<0.00) and had a significantly greater AUC (0.6 vs 0.5; P<0.006). Additionally, FpCT was more sensitive (65% vs 0%; P<0.00) in detecting plaques with ≤ 5% calcium (high attenuation foci) but not in detecting branch points. Both FpCT and histology allowed us to detect low-attenuation foci as small as 0.3mm in diameter, whereas 64-CT allowed us to detect only low-attenuation foci ≥ 1.5mm in diameter.

Conclusions: Flat-panel CT seemed to have more potential for quantitatively screening low-risk small atherosclerotic lesions, whereas 64-CT was apparently more useful when imaging established, well-characterized lesions, particularly when measuring the vascular wall thickness in a rabbit model of atherosclerosis.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Animals
  • Aorta / pathology
  • Aortography / methods
  • Aortography / standards*
  • Hyperlipidemias / complications
  • Hyperlipidemias / diagnostic imaging
  • Plaque, Atherosclerotic / diagnostic imaging*
  • Plaque, Atherosclerotic / etiology
  • Rabbits
  • Tomography, X-Ray Computed / methods
  • Tomography, X-Ray Computed / standards*
  • X-Ray Intensifying Screens / standards*