How early can atherosclerosis be detected by coronary CT angiography? Insights from quantitative CT analysis of serial scans in the PARADIGM trial.
Journal of cardiovascular computed tomography
BACKGROUND: Non-obstructing small coronary plaques may not be well recognized by expert readers during coronary computed tomography angiography (CCTA) evaluation. Recent developments in atherosclerosis imaging quantitative computed tomography (AI-QCT) enabled by machine learning allow for whole-heart coronary phenotyping of atherosclerosis, but its diagnostic role for detection of small plaques on CCTA is unknown.
METHODS: We performed AI-QCT in patients who underwent serial CCTA in the multinational PARADIGM study. AI-QCT results were verified by a level III experienced reader, who was blinded to baseline and follow-up status of CCTA. This retrospective analysis aimed to characterize small plaques on baseline CCTA and evaluate their serial changes on follow-up imaging. Small plaques were defined as a total plaque volume <50 >mm
RESULTS: A total of 99 patients with 502 small plaques were included. The median total plaque volume was 6.8 mm
CONCLUSION: In this retrospective analysis from the PARADIGM study, small plaques (<50 >mm
Cardoso R, Choi AD, Shiyovich A, Besser SA, Min JK, Earls J; PARADIGM Investigators et al [Chinnaiyan K]. How early can atherosclerosis be detected by coronary CT angiography? Insights from quantitative CT analysis of serial scans in the PARADIGM trial. J Cardiovasc Comput Tomogr. 2023 Oct 3:S1934-5925(23)00426-4. doi: 10.1016/j.jcct.2023.08.012. Epub ahead of print. PMID: 37798157.