Intracoronary transluminal attenuation gradient in coronary CT angiography for determining coronary artery stenosis

Jin Ho Choi, James K. Min, Troy M. Labounty, Fay Y. Lin, Dorinna D. Mendoza, Dae Hee Shin, Nikki S. Ariaratnam, Sunaina Koduru, Juan F. Granada, Thomas C. Gerber, Jae K. Oh, Hyeon Cheol Gwon, Yeon Hyeon Choe

Research output: Contribution to journalReview article

140 Scopus citations

Abstract

Coronary computed tomography angiography (CTA) assessment of calcified or complex coronary lesions is frequently challenging. Transluminal attenuation gradient (TAG), defined as the linear regression coefficient between luminal attenuation and axial distance, has a potential to evaluate the degree of coronary stenosis. We examined the value of TAG in determining the stenosis severity on 64-slice coronary CTA. The value of TAG of 370 major coronary arteries was measured from 7,263 intervals of 5-mm length. Compared with coronary CTA and invasive coronary angiography, TAG decreased consistently and significantly with maximum stenosis severity on a per-vessel basis, from -1.91 ± 4.25 Hounsfield units/10 mm for diameter stenosis of 0% to 49% to -13.37 ± 9.81 Hounsfield units/10 mm for diameter stenosis of 100% (p < 0.0001). Adding TAG to the interpretation of coronary CTA improved diagnostic accuracy (p = 0.001), especially in vessels with calcified lesions (N = 127; net reclassification improvement 0.095; p = 0.046). TAG appears to be able to contribute to improved classification of coronary artery stenosis severity in coronary CTA, especially in severely calcified lesions.

Original languageEnglish (US)
Pages (from-to)1149-1157
Number of pages9
JournalJACC: Cardiovascular Imaging
Volume4
Issue number11
DOIs
StatePublished - Nov 2011

Keywords

  • computed tomography
  • coronary artery imaging
  • diagnosis of coronary artery stenosis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Choi, J. H., Min, J. K., Labounty, T. M., Lin, F. Y., Mendoza, D. D., Shin, D. H., Ariaratnam, N. S., Koduru, S., Granada, J. F., Gerber, T. C., Oh, J. K., Gwon, H. C., & Choe, Y. H. (2011). Intracoronary transluminal attenuation gradient in coronary CT angiography for determining coronary artery stenosis. JACC: Cardiovascular Imaging, 4(11), 1149-1157. https://doi.org/10.1016/j.jcmg.2011.09.006