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Visualizing Calcified Plaques with Virtual Intravascular Endoscopy

Virtual_Intravascular_EndoscopySearching for screening techniques for the early detection of coronary artery disease, the leading cause of death in the Western world, represents one of the greatest challenges in the scientific field. While the occurrence of cardiovascular disease can be detected through imaging modalities such as coronary CT angiography, the presence of calcified plaques in the coronary artery walls often affects the diagnostic value of this scanning technique.

Coronary artery calcification is one of the risk factors that may lead to coronary artery disease. As calcium gradually builds up and forms layers of plaque in the inner surface of the arteries, blood vessels harden and become narrow over time (stenosis), limiting the blood supply going to the heart.

Determined to find an innovative approach for the differentiation of calcified plaques and the assessment of coronary lumen stenosis, researchers from Capital Medical University, Beijing, China, decided to test the feasibility of 3D virtual intravascular endoscopy.

In this study, Analyze software was used to post-process CT scans of coronary arteries from 61 patients with suspected coronary artery disease and to generate 3D virtual intravascular endoscopy images. Through this visualization tool, the team was able to characterize morphological features of the calcifications and distinguish between deep calcified plaques and superficial calcified plaques, which most commonly lead to acute coronary syndromes. Being able to visualize the intraluminal surface of the coronary arteries led to a more accurate assessment of lumen stenosis. In fact, results showed that plaque morphological features as detected on the 3D images directly correlated with the degree of lumen change.

3D virtual intravascular endoscopy was able to overcome the limitations that are usually experienced when using imaging techniques such as invasive coronary angiography, which can result in coronary lumen underestimation. The high diagnostic performance that can be achieved with the use of 3D virtual intravascular endoscopy represents a significant accomplishment in the prevention of cardiovascular disease.

Related: Coronary CT Angiography Gauges Heart Disease Severity

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