TY - JOUR
T1 - Clinical quantitative coronary artery stenosis and coronary atherosclerosis imaging
T2 - a Consensus Statement from the Quantitative Cardiovascular Imaging Study Group
AU - Mézquita, Aldo J Vázquez
AU - Biavati, Federico
AU - Falk, Volkmar
AU - Alkadhi, Hatem
AU - Hajhosseiny, Reza
AU - Maurovich-Horvat, Pál
AU - Manka, Robert
AU - Kozerke, Sebastian
AU - Stuber, Matthias
AU - Derlin, Thorsten
AU - Channon, Keith M
AU - Išgum, Ivana
AU - Coenen, Adriaan
AU - Foellmer, Bernhard
AU - Dey, Damini
AU - Volleberg, Rick H J A
AU - Meinel, Felix G
AU - Dweck, Marc R
AU - Piek, Jan J
AU - van de Hoef, Tim
AU - Landmesser, Ulf
AU - Guagliumi, Giulio
AU - Giannopoulos, Andreas A
AU - Botnar, René M
AU - Khamis, Ramzi
AU - Williams, Michelle C
AU - Newby, David E
AU - Dewey, Marc
N1 - Funding Information:
We thank the German Research Foundation (DFG) for funding the Second Quantitative Cardiovascular Imaging Meeting and this Consensus Statement on the quantitative assessment of coronary artery stenosis and atherosclerosis (DE 1361/22-1). This work was also supported by the DFG through its graduate programme on quantitative biomedical imaging (BIOQIC, GRK 2260/1, DFG project number: 289347353), the DFG Priority Programme Radiomics (DFG project number: 402688427) for the investigation of coronary plaque and coronary flow (DE 1361/19-1: DFG project number: 428222922 and DE 1361/20-1: DFG project number: 428223139 in SPP 2177/1), and the GUIDE-IT project on data sharing of medical imaging trials (DE 1361/24-1, DFG project number: 495697118).
Publisher Copyright:
© 2023, Springer Nature Limited.
PY - 2023/10
Y1 - 2023/10
N2 - The detection and characterization of coronary artery stenosis and atherosclerosis using imaging tools are key for clinical decision-making in patients with known or suspected coronary artery disease. In this regard, imaging-based quantification can be improved by choosing the most appropriate imaging modality for diagnosis, treatment and procedural planning. In this Consensus Statement, we provide clinical consensus recommendations on the optimal use of different imaging techniques in various patient populations and describe the advances in imaging technology. Clinical consensus recommendations on the appropriateness of each imaging technique for direct coronary artery visualization were derived through a three-step, real-time Delphi process that took place before, during and after the Second International Quantitative Cardiovascular Imaging Meeting in September 2022. According to the Delphi survey answers, CT is the method of choice to rule out obstructive stenosis in patients with an intermediate pre-test probability of coronary artery disease and enables quantitative assessment of coronary plaque with respect to dimensions, composition, location and related risk of future cardiovascular events, whereas MRI facilitates the visualization of coronary plaque and can be used in experienced centres as a radiation-free, second-line option for non-invasive coronary angiography. PET has the greatest potential for quantifying inflammation in coronary plaque but SPECT currently has a limited role in clinical coronary artery stenosis and atherosclerosis imaging. Invasive coronary angiography is the reference standard for stenosis assessment but cannot characterize coronary plaques. Finally, intravascular ultrasonography and optical coherence tomography are the most important invasive imaging modalities for the identification of plaques at high risk of rupture. The recommendations made in this Consensus Statement will help clinicians to choose the most appropriate imaging modality on the basis of the specific clinical scenario, individual patient characteristics and the availability of each imaging modality.
AB - The detection and characterization of coronary artery stenosis and atherosclerosis using imaging tools are key for clinical decision-making in patients with known or suspected coronary artery disease. In this regard, imaging-based quantification can be improved by choosing the most appropriate imaging modality for diagnosis, treatment and procedural planning. In this Consensus Statement, we provide clinical consensus recommendations on the optimal use of different imaging techniques in various patient populations and describe the advances in imaging technology. Clinical consensus recommendations on the appropriateness of each imaging technique for direct coronary artery visualization were derived through a three-step, real-time Delphi process that took place before, during and after the Second International Quantitative Cardiovascular Imaging Meeting in September 2022. According to the Delphi survey answers, CT is the method of choice to rule out obstructive stenosis in patients with an intermediate pre-test probability of coronary artery disease and enables quantitative assessment of coronary plaque with respect to dimensions, composition, location and related risk of future cardiovascular events, whereas MRI facilitates the visualization of coronary plaque and can be used in experienced centres as a radiation-free, second-line option for non-invasive coronary angiography. PET has the greatest potential for quantifying inflammation in coronary plaque but SPECT currently has a limited role in clinical coronary artery stenosis and atherosclerosis imaging. Invasive coronary angiography is the reference standard for stenosis assessment but cannot characterize coronary plaques. Finally, intravascular ultrasonography and optical coherence tomography are the most important invasive imaging modalities for the identification of plaques at high risk of rupture. The recommendations made in this Consensus Statement will help clinicians to choose the most appropriate imaging modality on the basis of the specific clinical scenario, individual patient characteristics and the availability of each imaging modality.
KW - Humans
KW - Coronary Artery Disease/diagnostic imaging
KW - Constriction, Pathologic
KW - Coronary Stenosis/diagnostic imaging
KW - Coronary Angiography/methods
KW - Atherosclerosis
KW - Plaque, Atherosclerotic/diagnostic imaging
UR - http://www.scopus.com/inward/record.url?scp=85160937774&partnerID=8YFLogxK
U2 - 10.1038/s41569-023-00880-4
DO - 10.1038/s41569-023-00880-4
M3 - Review article
C2 - 37277608
SN - 1759-5002
VL - 20
SP - 696
EP - 714
JO - Nature Reviews Cardiology
JF - Nature Reviews Cardiology
IS - 10
ER -