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Radiol Cardiothorac Imaging2026;8(4):e250117.August 1, 2026Journal Article

Association of Low-Attenuation Noncalcified Plaque Shape and Degree of Intraplaque Embeddedness Using Atherosclerotic Imaging-enabled Quantitative CT with Acute Coronary Syndrome.

Shant Malkasian1, Nick S Nurmohamed2, Hyuk-Jae Chang3, Andrew D Choi4, Hugo Marques5, Sabee Molloi6, Alexander van Rosendael7, Benjamin J W Chow8, Daniele Andreini9, Edoardo Conte9, Erica Maffei10, Fabian Plank11, Gianluca Pontone9, Gudrun Feuchtner12, Habib Samady13, Hyung-Bok Park14, Ibrahim Danad15, Iksung Cho4, Jeroen J Bax7, Hyun-Ji Lee4, Ji Min Sung4, Lohendran Baskaran16, Martin Hadamitzky17, Matthew J Budoff18, Peter H Stone19, Ran Heo20, Ricardo C Cury21, Sang-Eun Lee22, Subhi J Al'Aref23, Wijnand J Stuijfzand15, Yong-Jin Kim24, Filippo Cademartiri25, Renu Virmani26, Jagat Narula27, Kavitha Chinnaiyan28, Todd C Villines29, Jonathon Leipsic30, Leslee J Shaw31, Fay Y Lin31, Tami Crabtree32, Udo Hoffman32, James P Earls32,33
1Department of Radiology, University of California, San Diego, 9452 Medical Ctr Dr, La Jolla, CA 92037.
2Vascular Medicine, Amsterdam UMC, Amsterdam, the Netherlands.
3Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
4Division of Cardiology and Department of Radiology, The George Washington University School of Medicine, Washington, DC.
5Hospital da Luz, Lisbon, Portugal.
6Department of Radiological Sciences, University of California, Irvine School of Medicine, Irvine, Calif.
7Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
8Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada.
9Department of Cardiovascular Imaging, Centro Cardiologico Monzino, IRCCS, Milan, Italy.
10Department of Radiology, Area Vasta 1/ASUR Marche, Urbino, Italy.
11Department of Cardiology, Innsbruck Medical University, Innsbruck, Austria.
12Department of Radiology, Innsbruck Medical University, Innsbruck, Austria.
13Georgia Heart Institute, Gainesville, Ga.
14Department of Cardiology, International St Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea.
15Department of Cardiology, VU University Medical Center Amsterdam, Amsterdam, the Netherlands.
16National Heart Centre, Singapore.
17Department of Radiology and Nuclear Medicine, German Heart Center Munich, Munich, Germany.
18The Lundquist Institute, Harbor-UCLA Medical Center, Torrance, Calif.
19Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Mass.
20Hanyang University Medical Center, Seoul, Korea.
21Department of Radiology, Baptist Cardiac and Vascular Institute, Coral Gables, Fla.
22Seoul St. Mary's Hospital, Seoul, Korea.
23Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, Ark.
24Seoul National University Hospital, Seoul, Korea.
25Department of Radiology, Fondazione Toscana Gabriele Monasterio/CNR, Pisa, Italy.
26CVPath Institute, Gaithersburg, Md.
27University of Texas Health, Houston, Tex.
28Department of Cardiology, William Beaumont Hospital, Royal Oak, Mich.
29Department of Cardiology, University of Virginia Health System, Charlottesville, Va.
30Department of Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, Canada.
31Department of Medicine and Population Health Sciences, Icahn School of Medicine at Mount Sinai, New York, NY.
32Cleerly Inc, Denver, Colo.
33Department of Radiology, The George Washington University School of Medicine, Washington, DC.
PubMed DOI

Abstract

Purpose To assess the association of low-attenuation noncalcified plaque (LAP) morphologic features, including shape and degree of intraplaque embeddedness, using atherosclerotic imaging-enabled quantitative CT with acute coronary syndrome (ACS). Materials and Methods In this secondary analysis of the Incident Coronary Syndromes Identified by CT (ICONIC) study, a retrospective-nested, case-control…

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