Comparison of In Vivo Assessment of Vulnerable Plaque by 64-Slice Multislice Computed Tomography Versus Optical Coherence Tomography

The aim of this study was to investigate the possibility of 64-slice multislice computed tomography (MSCT) to detect vulnerable plaque derived by optical coherence tomography. From September 2007 through December 2009, 122 lesions in 81 patients were evaluated by 64-slice MSCT and optical coherence tomography. Based on optical coherence tomographic findings, lesions were classified as thin-capped fibroatheroma (TCFA; n = 37) and non-TCFA (n = 85). Mean computed tomographic density value of the lesion was lower and remodeling index was larger in the TCFA group (44.9 +/- 19.2 vs 78.7 +/- 25.0 HU, p < 0.0001; 1.14 +/- 0.20 vs 0.95 +/- 0.16, p < 0.0001, respectively). Mean computed tomographic density value was correlated and remodeling index was inversely correlated with fibrous cap thickness (r = 0.605, p < 0.0001; r = 0.591, p < 0.0001, respectively). Optimal threshold of mean computed tomographic value and remodeling index identified by receiver operating characteristic curve were 62.4 HU and >= 1.08 (area under the curve 0.859 and 0.781). Signet ringlike appearance was observed more frequently in the TCFA group (65% vs 16%, p < 0.0001). In multivariate analysis, independent predictors of TCFA were mean computed tomographic density value 62.4 HU (odds ratio 8.20, 95% confidential interval 2.49 to 27.0, p = 0.0005), remodeling index >= 1.08 (odds ratio 6.10, 95% confidential interval 2.04 to 18.2, p = 0.0012), and signet ringlike appearance (odds ratio 6.33, 95% confidential interval 2.03 to 19.7, p = 0.0014). In conclusion, based on comparisons with optical coherence tomographic findings, 64-slice MSCT may have the potential to detect vulnerable plaque. (C) 2011 Elsevier Inc. All rights reserved. (Am J Cardiol 2011;107: 1270-1277)