Accuracy of computed tomography angiography to identify thin-cap fibroatheroma detected by optical coherence tomography

Abstract Background Thin-cap fibroatheroma (TCFA) is assumed to cause acute coronary syndromes. Objective To compare the accuracy of different models for diagnosing TCFA using parameters derived by CT, validated against optical coherence tomography (OCT). Methods One hundred twenty-nine plaques in 106 patients were analyzed using data acquired by 64-row CT with a reconstruction thickness of 0.67 mm and an increment of 0.33 mm. TCFA was defined by OCT as a plaque with lipid content in ≥2 quadrants and the thinnest part of the fibrous cap measuring ≤65 μm. The following parameters were obtained from CT: remodeling index (RI), proportion of low-attenuation (LA) volume ( 1.1, minimum CT number 1.1, minimum CT number