ArticleInterdisciplinary cardiovascular and thoracic surgery2025
Ultra-high-resolution and dual-energy computed tomography of carotid artery plaques differentiate symptomatic and asymptomatic patients by novel volumetric analysis.
Article in Interdisciplinary cardiovascular and thoracic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Multimodal ultrasound and computed tomography imaging may improve the discrimination between symptomatic and asymptomatic patients with carotid stenosis.American heart journal plus : cardiology research and practice · 2026Article
- Comparison of Carotid Plaque Ultrasound and Computed Tomography in Patients and Ex Vivo Specimens-Agreement of Composition Analysis.Journal of clinical medicine · 2026Article
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13 authors.
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Abstract
objectivesThe indication for carotid endarterectomy (CEA) mainly relies on the degree of stenosis and neurological symptoms. Plaque vulnerability has been associated with stroke risk, but identification on single-energy computed tomography (CT) has yielded heterogeneous results and is not routinely applied to clinical diagnostics. Hence, we intended to analyse CEA specimens for vulnerability features using dual-source CT and correlate these features with the presence of preprocedural symptoms.
methodsCT was performed on 187 carotid plaque specimens using ultra-high-resolution and dual-energy imaging on a dual-source scanner. Plaques were separated into calcified versus non-calcified volumes and analysed concerning HU-density, calcifications and volumetric dual-energy indices (DEIs). Comparative statistical analysis of plaque characteristics was performed with respect to the presence of neurological symptoms.
resultsThe degree of stenosis of symptomatic and asymptomatic plaques was indifferent (69.2 ± 12.3% vs 66.3 ± 13.7%). The highest diagnostic accuracies were obtained by the % calcified volume (AUC 0.63 (0.54-0.71)), average whole plaque HU (AUC 0.71 (0.64-0.79)), profound calcification (AUC 0.74 (0.66-0.81)), calcification spots <1 mm (AUC 0.71 (0.63-0.79)) and spotty calcification (AUC 0.74 (0.66-0.82)). The diagnostic accuracy for symptomatic plaques was insignificant using average non-calcified plaque HU (AUC 0.59 (0.48-0.65)), but significant using average non-calcified plaque DEI (AUC 0.66 (0.58-0.74)).
conclusionsSymptomatic plaques were identified best by measuring density of the whole, calcified or non-calcified plaque and via spotty, profoundly localized and less dense calcification. A volumetric DEI identifies symptomatic plaques with non-calcified plaque characteristics more accurately than single-energy CT. Future clinical studies are necessary to confirm these findings in patients.
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