Characterization of Coronary Atherosclerotic Plaque in Ex-vivo Human Coronary Arteries Using High Definition Computed Tomography in Comparison to Intravascular Ultrasound, Optical Coherence Tomography and Histology

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Coronary heart disease is the manifestation of atherosclerosis in the coronary vessels. In the early stages of disease patients are asymptomatic. In nearly 50% of patients suffering from coronary heart disease, a coronary event is the primary manifestation of the disease. The majority of these events are caused by rupture of the atherosclerotic plaque followed by thrombotic occlusion of the vessel. A certain type of plaque, coined the vulnerable plaque, is especially prone to rupture. The plaques have been shown to have a thin fibrous cap covering a large lipid core. The identification these vulnerable plaques has been the subject of intense research. This includes advances such as intravascular ultrasound, thermography and optical coherence tomography. However, these are invasive techniques that are associated with a certain rate of complications. At he same time non-invasive techniques for coronary imaging such computed tomography (CT) have gained widespread acceptance in diagnosing coronary heart disease. The aim of the present study is to evaluate whether a new detector technology for cardiac CT that offers both an increased special resolution as well as the possibility to perform monochromatic reconstructions within the spectrum of the x-ray beam, can reliably identify these lipid rich plaques.