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The estimation of coronary artery calcium thickness by computed tomography angiography based on optical coherence tomography measurements

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Abstract

Optical coherence tomography (OCT) is recommended to be the most appropriate modality in assessing calcium thickness, however, it has limitations associated with infrared attenuation. Although coronary computed tomography angiography (CCTA) detects calcification, it has low resolution and hence not recommended to measure the calcium size. The aim of this study was to devise a simple algorithm to estimate calcium thickness based on the CCTA image. A total of 68 patients who had CCTA for suspected coronary artery disease and subsequently went on to have OCT were included in the study. 238 lesions of them divided into derivation and validation dataset at 2:1 ratio (47 patients with 159 lesions and 21 with 79, respectively) were analyzed. A new method was developed to estimate calcium thickness from the maximum CT density within the calcification and compared with calcium thickness measured by OCT. Maximum Calcium density and measured calcium-border CT density had a good correlation with a linear equation of y = 0.58x + 201 (r = 0.892, 95% CI 0.855–0.919, p < 0.001). The estimated calcium thickness derived from this equation showed strong agreement with measured calcium thickness in validation and derivation dataset (r2 = 0.481 and 0.527, 95% CI 0.609–0.842 and 0.497–0.782, p < 0.001 in both, respectively), more accurate than the estimation by full width at half maximum and inflection point method. In conclusion, this novel method provided the estimation of calcium thickness more accurately than conventional methods.

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Data availability

The all supporting data of this study are available from the corresponding author upon reasonable request.

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Funding

The authors have no relevant financial or non-financial interests to disclose.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, New Tokyo Hospital, 1271, Wanagaya, Matsudo, Chiba, 270-2232, Japan

    Masaaki Okutsu, Satoru Mitomo, Hirokazu Onishi, Akihiro Nakajima, Hiroto Yabushita, Satoshi Matsuoka, Hiroyoshi Kawamoto, Yusuke Watanabe, Kentaro Tanaka, Toru Naganuma, Satoko Tahara, Shotaro Nakamura & Sunao Nakamura

  2. Department of Cardiology, Heartlands Hospital, University Hospitals Birmingham, Birmingham, UK

    Sandeep Basavarajaiah

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  1. Masaaki Okutsu
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  2. Satoru Mitomo
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  3. Hirokazu Onishi
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  4. Akihiro Nakajima
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  13. Sandeep Basavarajaiah
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Correspondence to Masaaki Okutsu.

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Okutsu, M., Mitomo, S., Onishi, H. et al. The estimation of coronary artery calcium thickness by computed tomography angiography based on optical coherence tomography measurements. Heart Vessels 38, 1305–1317 (2023). https://doi.org/10.1007/s00380-023-02286-1

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  • DOI: https://doi.org/10.1007/s00380-023-02286-1

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