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A meta analysis and hierarchical classification of HU-based atherosclerotic plaque characterization criteria.
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.
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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
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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. Related in: MedlinePlus |
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pone-0073460-g002: HU criteria for lipid-rich and fibrous plaques versus the reported lumen contrast-enhancement. Mentions: Pooling all published HU-criteria, the values for lipid-rich and fibrous plaques were: 47 + 29 HU and 86 + 29 HU, respectively. The published mean HU-criteria showed a low correlation with lumen contrast-enhancement, for lipid-rich (r2 = 0.0054 ; p > 0.05) and fibrous plaques (r2 = 0.0304; p < 0.05) (Figure 2). |
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.
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.
