Coronary Plaque Quantification Using a New CT Imaging Software—A Feasibility Study

Background: Intraoperative accidentally finding of nonobstructive plaques can lead to challenges with coronary anastomoses. Cardiac CT has the potential to detect plaques preoperatively, but conventional 2D visualization might be difficult to understand and interpret.

The Cinematic Rendering (CR) algorithm provides photorealistic representation of 3D images with true depth and form perception.

Aim: of this feasibility study was to evaluate the potential benefit of CR visualization in correlation with intraoperative palpation of nonobstructive coronary plaques.

Methods: We included all consecutive patients who underwent cardiac surgery with full sternotomy and previous cardiac CT scans. All CT scans were analyzed using CR and different pre-sets were tested to visualize the plaques. The coronary arteries were quantified from 1 (no plaque) to 5 (severe plaque) for all 15 standard segments. Intraoperative palpation was performed after pericardiotomy and the coronary arteries were quantified with the same scale as in CT.

Results: 26 patients (mean age 70 ± 9, 17% female) were included. We created 3 pre-sets with reliable plaque visualization. Bland Altman plot showed excellent correlation between intraoperative palpation and CR in all segments (mean difference 0.1). CR would have influenced the location of coronary anastomosis in 78% of coronaries.

Conclusion: Plaque evaluation of coronary arteries using Cinematic Rendering perfectly correlates with intraoperative palpation. The photorealistic 3-dimensional images of the cardiac anatomy allow for easier interpretation of the plaque localization. These preliminary results already demonstrate the enormous potential of CR in coronary artery bypass surgery. Coronary anastomoses site can be better planned with less intraoperative ‘surprises’ of plaques that were not visualized in coronary angiography. More patients will be included and correlation with coronary angiography will be performed.

Publikationsverlauf

Artikel online veröffentlicht:
13. Februar 2024