Artificial addition of calcium-like elements to the atherosclerotic plaque led to an increase in necrotic tissue in virtual histology that is probably artefactual. The overestimation of necrotic tissue by calcium strictly followed a linear pattern, indicating that it may be amenable to mathematical correction.

Virtual Histology (VH) is a new medical imaging technique that allows the assessment of atherosclerotic plaque composition, a potential useful tool for the evaluation of individuals with coronary disease. Empirical observation has suggested that plaque areas adjacent to dense calcium (DC) are frequently coded as necrotic core (NC) in VH images. The main objective of the study was to evaluate whether the presence of DC induces an artifactual coding of NC in adjacent structures. To test this effect, a set of 89 coronary arteries segments have been analyzed in baseline and after stent implantation, which are coded as dense calcium into VH images. Necrotic tissue has risen significantly after stenting, especially in regions surrounding dense calcium structures, reinforcing the hypothesis of an artifactual relationship between those plaque components.

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