Components of carotid atherosclerotic plaque in spectral photon-counting CT with histopathologic comparison.
| Title: | Components of carotid atherosclerotic plaque in spectral photon-counting CT with histopathologic comparison. |
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| Authors: | Dahal S; University of Maryland, Baltimore, USA. shishirradio@gmail.com.; Raja AY; Department of Physics, Khalifa University, Abu Dhabi, UAE.; Searle E; University of Canterbury, Christchurch, New Zealand.; Colgan FE; Department of Clinical Radiology, Christchurch Hospital, Canterbury District Health Board, Christchurch, New Zealand.; Crighton JS; Department of Clinical Radiology, Christchurch Hospital, Canterbury District Health Board, Christchurch, New Zealand.; Roake J; Department of Vascular Surgery, Christchurch Hospital, Canterbury District Health Board, Christchurch, New Zealand.; Saba L; Department of Medical Science and Public Health, University of Cagliari, Sardinia, Italy.; Gieseg S; School of Biological Science, University of Canterbury, Christchurch, New Zealand.; Butler APH; Department of Clinical Radiology, Christchurch Hospital, Canterbury District Health Board, Christchurch, New Zealand.; Department of Academic Radiology, University of Otago, Christchurch, New Zealand. |
| Source: | European radiology [Eur Radiol] 2023 Mar; Vol. 33 (3), pp. 1612-1619. Date of Electronic Publication: 2022 Oct 07. |
| Publication Type: | Observational Study; Journal Article |
| Language: | English |
| Journal Info: | Publisher: Springer International Country of Publication: Germany NLM ID: 9114774 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-1084 (Electronic) Linking ISSN: 09387994 NLM ISO Abbreviation: Eur Radiol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Berlin : Springer International, c1991- |
| MeSH Terms: | Plaque, Atherosclerotic*/diagnostic imaging ; Plaque, Atherosclerotic*/pathology; Carotid Arteries/diagnostic imaging ; Carotid Arteries/pathology ; Male ; Humans ; Reproducibility of Results ; Cross-Sectional Studies ; Tomography, X-Ray Computed ; Fibrosis |
| Abstract: | Objectives: This study aimed to demonstrate the effectiveness of spectral photon-counting CT (SPCCT) in quantifying fibrous cap (FC) thickness, FC area, and lipid-rich necrotic core (LRNC) area, in excised carotid atherosclerotic plaques by comparing it with histopathological measurements.; Methods: This is a single-center ex vivo cross-sectional observational study. Excised plaques of 20 patients (71 +/- 6 years; 13 men), obtained from carotid endarterectomy were scanned with SPCCT using standardized acquisition settings (120k Vp/19 μA; 7-18 keV, 18-30 keV, 30-45 keV, 45-75 keV, and 75-118 keV). FC thickness, FC area, and LRNC area were quantified and compared between high-resolution 3D multi-energy CT images and histopathology using the Wilcoxon signed-ranks test and Bland-Altman analysis. Images were interpreted twice by two radiologists separately, blinded to the histopathology; inter- and intra-rater reliability were assessed with the intra-class correlation coefficients (ICC).; Results: FC thickness and FC area did not show significant differences between the SPCCT-derived radiological measurements versus the histopathological measurements (p value range 0.15-0.51 for FC thickness and 0.053-0.30 for FC area). For the LRNC area, the p value was statistically non-significant for reader 1 (range 0.36-0.81). The Bland-Altman analysis showed mean difference and 95% confidence interval for FC thickness, FC area, and LRNC area, 0.04 (-0.36 to 0.12) square root mm, -0.18 (-0.34 to -0.02) log10 mm2 and 0.10 (-0.088. to 0.009) log10 mm2 respectively.; Conclusion: The result demonstrated a viable technique for quantifying FC thickness, FC area, and LRNC area due to the combined effect of high spatial and energy resolution of SPCCT.; Key Points: • SPCCT can identify and quantify different components of carotid atherosclerotic plaque in ex vivo study. • Components of atherosclerotic plaque did not show significant differences between the SPCCT-derived radiological measurements versus the histopathological measurements.; (© 2022. The Author(s), under exclusive licence to European Society of Radiology.) |
| Comments: | Erratum in: Eur Radiol. 2023 Dec;33(12):9479. doi: 10.1007/s00330-023-09849-w.. (PMID: 37389611) |
| References: | World Health Organization (2018) WHO methods and data sources for global burden of disease estimates 2000-2016. Global Health Estimates Technical Paper WHO/HIS/IER/GHE/20184, WHO, Geneva.; Ooi YC, Gonzalez NR (2015) Management of extracranial carotid artery disease. Cardiol Clin 33:1–35. (PMID: 10.1016/j.ccl.2014.09.001254393284694631); Insull W Jr (2009) The pathology of atherosclerosis: plaque development and plaque responses to medical treatment. Am J Med 122:S3–S14. (PMID: 10.1016/j.amjmed.2008.10.01319110086); Shah PK (2003) Mechanisms of plaque vulnerability and rupture. J Am Coll Cardiol 41:S15–S22. (PMID: 10.1016/S0735-1097(02)02834-6); Mughal MM, Khan MK, DeMarco JK, Majid A, Shamoun F, Abela GS (2011) Symptomatic and asymptomatic carotid artery plaque. Expert Rev Cardiovasc Ther 9:1315–1330. (PMID: 10.1586/erc.11.120219855443243497); Brinjikji W, Huston J, Rabinstein AA, Kim G-M, Lerman A, Lanzino G (2016) Contemporary carotid imaging: from degree of stenosis to plaque vulnerability. J Neurosurg 124:27–42. (PMID: 10.3171/2015.1.JNS14245226230478); Saba L, Saam T, Jäger HR et al (2019) Imaging biomarkers of vulnerable carotid plaques for stroke risk prediction and their potential clinical implications. Lancet Neurol 18:559–572. (PMID: 10.1016/S1474-4422(19)30035-330954372); Lin E, Alessio A (2009) What are the basic concepts of temporal, contrast, and spatial resolution in cardiac CT? J Cardiovasc Comput Tomogr 3:403–408. (PMID: 10.1016/j.jcct.2009.07.003197173554752333); Rothwell PM, Eliasziw M, Gutnikov SA et al (2003) Analysis of pooled data from the randomised controlled trials of endarterectomy for symptomatic carotid stenosis. Lancet 361:107–116. (PMID: 10.1016/S0140-6736(03)12228-312531577); Hellings WE, Peeters W, Moll FL et al (2010) Composition of carotid atherosclerotic plaque is associated with cardiovascular outcome: a prognostic study. Circulation 121:1941–1950. (PMID: 10.1161/CIRCULATIONAHA.109.88749720404256); Ballabriga R, Alozy J, Campbell M et al (2016) Review of hybrid pixel detector readout ASICs for spectroscopic X-ray imaging. J Instrum 11:P01007. (PMID: 10.1088/1748-0221/11/01/P01007); Panta RK, Butler APH, Butler PH et al First human imaging with MARS photon-counting CT2018 IEEE Nuclear Science Symposium and Medical Imaging Conference Proceedings (NSS/MIC). IEEE, pp 1-7.; Marfo E, Anderson NG, Butler APH et al (2020) Assessment of material identification errors, image quality and radiation doses using small animal spectral photon-counting CT. IEEE Trans Radiat Plasma Med Sci 5:578–587. (PMID: 10.1109/TRPMS.2020.3003260); Panta RK, Walsh MF, Bell ST, Anderson NG, Butler AP, Butler PH (2014) Energy calibration of the pixels of spectral x-ray detectors. IEEE Trans Med Imaging 34:697–706. (PMID: 10.1109/TMI.2014.233788125051546); Butler PH, Adebileje SA, Alexander SD et al MARS pre-clinical imaging: the benefits of small pixels and good energy dataDevelopments in X-Ray Tomography XII. International Society for Optics and Photonics, pp 111130C–111130C.; Aamir R, Chernoglazov A, Bateman CJ et al (2014) MARS spectral molecular imaging of lamb tissue: data collection and image analysis. J Instrum 9:P02005–P02005. (PMID: 10.1088/1748-0221/9/02/P02005); Raja AY, Moghiseh M, Bateman CJ et al (2018) Measuring identification and quantification errors in spectral CT material decomposition. Appl Sci 8:467. (PMID: 10.3390/app8030467); Bateman CJ, Knight D, Brandwacht B et al (2018) MARS-MD: rejection based image domain material decomposition. J Instrum 13:P05020. (PMID: 10.1088/1748-0221/13/05/P05020); Stary HC, Chandler AB, Dinsmore RE et al (1995) A definition of advanced types of atherosclerotic lesions and a histological classification of atherosclerosis: a report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. Circulation 92:1355–1374. (PMID: 10.1161/01.CIR.92.5.13557648691); Grant EG, Benson CB, Moneta GL et al (2003) Carotid artery stenosis: gray-scale and Doppler US diagnosis—Society of Radiologists in Ultrasound Consensus Conference. Radiology 229:340–346. (PMID: 10.1148/radiol.229203051614500855); Stary HC (2000) Natural history and histological classification of atherosclerotic lesions: an update. Arterioscler Thromb Vasc Biol 20:1177–1178. (PMID: 10.1161/01.ATV.20.5.117710807728); Zainon R, Ronaldson JP, Janmale T et al (2012) Spectral CT of carotid atherosclerotic plaque: comparison with histology. Eur Radiol 22:2581–2588. (PMID: 10.1007/s00330-012-2538-722760344); Cai J, Hatsukami TS, Ferguson MS et al (2005) In vivo quantitative measurement of intact fibrous cap and lipid-rich necrotic core size in atherosclerotic carotid plaque: comparison of high-resolution, contrast-enhanced magnetic resonance imaging and histology. Circulation 112:3437–3444. (PMID: 10.1161/CIRCULATIONAHA.104.52817416301346); Den Hartog A, Bovens S, Koning W et al (2013) Current status of clinical magnetic resonance imaging for plaque characterisation in patients with carotid artery stenosis. Eur J Vasc Endovasc Surg 45:7–21. (PMID: 10.1016/j.ejvs.2012.10.022); Stephens K (2021) FDA Approves Siemens Healthineers’ Naeotom Alpha CT Scanner. AXIS Imaging News.; Koenig T, Hamann E, Procz S et al (2013) Charge summing in spectroscopic x-ray detectors with high-Z sensors. IEEE Trans Nucl Sci 60:4713–4718. (PMID: 10.1109/TNS.2013.2286672) |
| Grant Information: | UOCX1404 Ministry of Business, Innovation and Employment |
| Contributed Indexing: | Keywords: Endarterectomy, carotid; Human; Plaque, atherosclerotic; Reproducibility of studies; Tomography, X-ray computed |
| Entry Date(s): | Date Created: 20221007 Date Completed: 20230222 Latest Revision: 20230630 |
| Update Code: | 20260130 |
| DOI: | 10.1007/s00330-022-09155-x |
| PMID: | 36205768 |
| Database: | MEDLINE |
Observational Study; Journal Article