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A meta analysis and hierarchical classification of HU-based atherosclerotic plaque characterization criteria.

Kristanto W, van Ooijen PM, Jansen-van der Weide MC, Vliegenthart R, Oudkerk M - PLoS ONE (2013)

Bottom Line: No correlation was found between HU-criteria and the reported lumen contrast-enhancement.Significant differences were found for HU-criteria when pooled according to the respective study characteristics: examination type, vessel type, CT-vendor, detector-rows, voltage-setting, and collimation-width.In conclusion, variations in the reported CT attenuation values for lipid-rich and fibrous plaque are so large that generalized values are unreliable for clinical use.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Center for Medical Imaging - North East, Netherlands, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

ABSTRACT

Background: Many computed tomography (CT) studies have reported that lipid-rich, presumably rupture-prone atherosclerotic plaques can be characterized according to their Hounsfield Unit (HU) value. However, the published HU-based characterization criteria vary considerably. The present study aims to systematically analyze these values and empirically derive a hierarchical classification of the HU-based criteria which can be referred in clinical situation.

Material and methods: A systematic search in PubMed and Embase for publications with HU-criteria to characterize lipid-rich and fibrous atherosclerotic plaques resulted in 36 publications, published between 1998 and 2011. The HU-criteria were systematically analyzed based on the characteristics of the reporting study. Significant differences between HU-criteria were checked using Student's t-test. Subsequently, a hierarchical classification of HU-criteria was developed based on the respective study characteristics.

Results: No correlation was found between HU-criteria and the reported lumen contrast-enhancement. Significant differences were found for HU-criteria when pooled according to the respective study characteristics: examination type, vessel type, CT-vendor, detector-rows, voltage-setting, and collimation-width. The hierarchical classification resulted in 21 and 22 CT attenuation value categories, for lipid-rich and fibrous plaque, respectively. More than 50% of the hierarchically classified HU-criteria were significantly different.

Conclusion: In conclusion, variations in the reported CT attenuation values for lipid-rich and fibrous plaque are so large that generalized values are unreliable for clinical use. The proposed hierarchical classification can be used to determine reference CT attenuation values of lipid-rich and fibrous plaques for the local setting.

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Related in: MedlinePlus

Search strategy and result.
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pone-0073460-g001: Search strategy and result.

Mentions: With the guidance of a librarian and using denominator terms for several relevant publications obtained beforehand, a computerized search was performed per April 22nd, 2011 to identify relevant publications in Pubmed, using MeSH terms and free text keywords: ("Ultrasonography, Interventional"[Mesh] OR "Coronary Artery Disease"[Mesh] OR "Carotid Artery Diseases"[Mesh]) AND plaque* AND "Tomography, X-Ray Computed"[Mesh] NOT "Review"[Publication Type]; and in Embase, using the keywords: ('endoscopic echography'/exp OR 'coronary artery disease'/exp OR 'carotid artery disease'/exp) AND 'plaque' AND 'computer assisted tomography'/exp NOT 'review'/exp/. Inclusion criteria for publication selection were: 1) original publication; 2) characterization of non-calcified plaques into lipid-rich and fibrous plaques, and report of their specific HU values; 3) using human derived materials; and 4) using other an imaging modality as plaque composition reference. Publications meeting one or more of the defined exclusion criteria were excluded (Figure 1).


A meta analysis and hierarchical classification of HU-based atherosclerotic plaque characterization criteria.

Kristanto W, van Ooijen PM, Jansen-van der Weide MC, Vliegenthart R, Oudkerk M - PLoS ONE (2013)

Search strategy and result.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3760884&req=5

pone-0073460-g001: Search strategy and result.
Mentions: With the guidance of a librarian and using denominator terms for several relevant publications obtained beforehand, a computerized search was performed per April 22nd, 2011 to identify relevant publications in Pubmed, using MeSH terms and free text keywords: ("Ultrasonography, Interventional"[Mesh] OR "Coronary Artery Disease"[Mesh] OR "Carotid Artery Diseases"[Mesh]) AND plaque* AND "Tomography, X-Ray Computed"[Mesh] NOT "Review"[Publication Type]; and in Embase, using the keywords: ('endoscopic echography'/exp OR 'coronary artery disease'/exp OR 'carotid artery disease'/exp) AND 'plaque' AND 'computer assisted tomography'/exp NOT 'review'/exp/. Inclusion criteria for publication selection were: 1) original publication; 2) characterization of non-calcified plaques into lipid-rich and fibrous plaques, and report of their specific HU values; 3) using human derived materials; and 4) using other an imaging modality as plaque composition reference. Publications meeting one or more of the defined exclusion criteria were excluded (Figure 1).

Bottom Line: No correlation was found between HU-criteria and the reported lumen contrast-enhancement.Significant differences were found for HU-criteria when pooled according to the respective study characteristics: examination type, vessel type, CT-vendor, detector-rows, voltage-setting, and collimation-width.In conclusion, variations in the reported CT attenuation values for lipid-rich and fibrous plaque are so large that generalized values are unreliable for clinical use.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Center for Medical Imaging - North East, Netherlands, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

ABSTRACT

Background: Many computed tomography (CT) studies have reported that lipid-rich, presumably rupture-prone atherosclerotic plaques can be characterized according to their Hounsfield Unit (HU) value. However, the published HU-based characterization criteria vary considerably. The present study aims to systematically analyze these values and empirically derive a hierarchical classification of the HU-based criteria which can be referred in clinical situation.

Material and methods: A systematic search in PubMed and Embase for publications with HU-criteria to characterize lipid-rich and fibrous atherosclerotic plaques resulted in 36 publications, published between 1998 and 2011. The HU-criteria were systematically analyzed based on the characteristics of the reporting study. Significant differences between HU-criteria were checked using Student's t-test. Subsequently, a hierarchical classification of HU-criteria was developed based on the respective study characteristics.

Results: No correlation was found between HU-criteria and the reported lumen contrast-enhancement. Significant differences were found for HU-criteria when pooled according to the respective study characteristics: examination type, vessel type, CT-vendor, detector-rows, voltage-setting, and collimation-width. The hierarchical classification resulted in 21 and 22 CT attenuation value categories, for lipid-rich and fibrous plaque, respectively. More than 50% of the hierarchically classified HU-criteria were significantly different.

Conclusion: In conclusion, variations in the reported CT attenuation values for lipid-rich and fibrous plaque are so large that generalized values are unreliable for clinical use. The proposed hierarchical classification can be used to determine reference CT attenuation values of lipid-rich and fibrous plaques for the local setting.

Show MeSH
Related in: MedlinePlus