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BACKGROUND: High pericoronary adipose tissue (PCAT) attenuation and non-calcified plaque burden (NCP) measured from coronary CT angiography (CTA) have been implicated in future cardiac events. We aimed to evaluate the interobserver and intraobserver repeatability of PCAT attenuation and NCP burden measurement from CTA, in a sub-study of the prospective SCOT-HEART trial. METHODS: Fifty consecutive CTAs from participants of the CT arm of the prospective SCOT-HEART trial were included. Two experienced observers independently measured PCAT attenuation and plaque characteristics throughout the whole coronary tree from CTA using semi-automatic quantitative software. RESULTS: We analyzed proximal segments in 157 vessels. Intraobserver mean differences in PCAT attenuation and NCP plaque burden were -0.05HU and 0.92% with limits of agreement (LOA) of ±1.54 and ± 5.97%. Intraobserver intraclass correlation coefficients (ICC) for PCAT attenuation and NCP burden were excellent (0.999 and 0.978). Interobserver mean differences in PCAT attenuation and NCP plaque burden were 0.13HU [LOA ±1.67HU] and -0.23% (LOA ±9.61%). Interobserver ICC values for PCAT attenuation and NCP burden were excellent (0.998 and 0.944). CONCLUSION: PCAT attenuation and NCP burden on CTA has high intraobserver and interobserver repeatability, suggesting they represent a repeatable and robust method of quantifying cardiovascular risk.

Original publication




Journal article


J cardiovasc comput tomogr

Publication Date





81 - 84


Computed tomography angiography, Coronary artery disease, Non-calcified plaque, Pericoronary adipose tissue, Repeatability, Adipose Tissue, Computed Tomography Angiography, Coronary Angiography, Coronary Artery Disease, Coronary Vessels, Female, Heart Disease Risk Factors, Humans, Male, Middle Aged, Multidetector Computed Tomography, Observer Variation, Plaque, Atherosclerotic, Predictive Value of Tests, Reproducibility of Results, Risk Assessment, Scotland, Severity of Illness Index