Consistency in Geometry Among Coronary Atherosclerotic Plaques Extracted From Computed Tomography Angiography

Haipeng Liu, Aleksandra Wingert, Xinhong Wang, Jucheng Zhang, Jianzhong Sun, Fei Chen, Syed Ghufran Khalid, Yinglan Gong, Ling Xia, Jun Jiang, Jian'an Wang, Dingchang Zheng

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    Background: The three-dimensional (3D) geometry of coronary atherosclerotic plaques is associated with plaque growth and the occurrence of coronary artery disease. However, there is a lack of studies on the 3D geometric properties of coronary plaques. We aim to investigate if coronary plaques of different sizes are consistent in geometric properties. Methods: Nineteen cases with symptomatic stenosis caused by atherosclerotic plaques in the left coronary artery were included. Based on attenuation values on computed tomography angiography images, coronary atherosclerotic plaques and calcifications were identified, 3D reconstructed, and manually revised. Multidimensional geometric parameters were measured on the 3D models of plaques and calcifications. Linear and non-linear (i.e., power function) fittings were used to investigate the relationship between multidimensional geometric parameters (length, surface area, volume, etc.). Pearson correlation coefficient (r), R-squared, and p-values were used to evaluate the significance of the relationship. The analysis was performed based on cases and plaques, respectively. Significant linear relationship was defined as R-squared > 0.25 and p < 0.05. Results: In total, 49 atherosclerotic plaques and 56 calcifications were extracted. In the case-based analysis, significant linear relationships were found between number of plaques and number of calcifications (r = 0.650, p = 0.003) as well as total volume of plaques (r = 0.538, p = 0.018), between number of calcifications and total volume of plaques (r = 0.703, p = 0.001) as well as total volume of calcification (r = 0.646, p = 0.003), and between the total volumes of plaques and calcifications (r = 0.872, p < 0.001). In plaque-based analysis, the power function showed higher R-squared values than the linear function in fitting the relationships of multidimensional geometric parameters. Two presumptions of plaque geometry in different growth stages were proposed with simplified geometric models developed. In the proposed models, the exponents in the power functions of geometric parameters were in accordance with the fitted values. Conclusion: In patients with coronary artery disease, coronary plaques and calcifications are positively related in number and volume. Different coronary plaques are consistent in the relationship between geometry parameters in different dimensions.
    Original languageEnglish
    Article number715265
    Number of pages12
    JournalFrontiers in Physiology
    Publication statusPublished - 12 Oct 2021

    Bibliographical note

    This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    Publisher Copyright:
    © Copyright © 2021 Liu, Wingert, Wang, Zhang, Sun, Chen, Khalid, Gong, Xia, Jiang, Wang and Zheng.


    Funding Information:
    This study was supported by the National Natural Science Foundation of China (Grant No. 61828104), the Zhejiang

    Funding Information:
    We acknowledge the Medical Technology Research Centre of Anglia Ruskin University for their kind support.


    • atherosclerotic plaques
    • computed tomography (CT)
    • coronary artery disease
    • plaque morphology
    • three-dimensional reconstruction

    ASJC Scopus subject areas

    • Physiology
    • Physiology (medical)


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