Prediction of optical coherence tomography-detected calcified nodules using coronary computed tomography angiography

Abstract

Abstract Diagnosis of Calcified nodules (CNs) is critical in proper management of coronary artery disease but CNs can be detected only using intracoronary imaging modalities. This study aimed to investigate the ability of coronary computed tomography angiography (CCTA) in predicting CNs detected by optical coherence tomography (OCT). In total, 138 patients (249 vessels) who underwent OCT after CCTA evaluation were retrospectively enrolled and classified into CN (11 patients / 12 vessels) and non-CN (127 patients / 237 vessels) groups based on the OCT analysis. Retrospective CCTA analysis revealed that coronary artery calcification score (CACS), calcified plaque volume (CPV), non-calcified plaque volume (NCPV), low-attenuation plaque volume (LAPV), and maximum calcified plaque area (MCPA) in the target vessel were significantly larger in the CN group than in non-CN group. Receiver operating characteristic curve indicated that CACS ≥ 162 (area under the ROC curve (AUC 0.86, sensitivity 83.3%, specificity 71.3%), CPV ≥ 20.2 mm3 (AUC 0.88, sensitivity 91.7%, specificity 70.5%), NCPV ≥ 1737 mm3 (AUC 0.71, sensitivity 75.0%, specificity 72.6%), LAPV ≥ 358 mm³ (AUC 0.71, sensitivity 91.7%, specificity 52.7%), and MCPA ≥ 4.51 mm² (AUC 0.9, sensitivity 91.7%, specificity 84.0%) were the best cutoff value for predicting CNs. Therefore, CCTA is useful for predicting OCT-detected CNs.