An MRI-based method to register patient-specific wall shear stress data to histology

Moerman, A. M.; Dilba, Kristine; Korteland, Suze-Anne; Poot, Dirk H. J.; Klein, Stefan; Lugt, Aad van der; Rouwet, Ellen V.; Gaalen, Kim van; Wentzel, Jolanda J.; Steen, Antonius F.W. van der; Gijsen, Frank; Heiden, Kim van der

doi:10.1371/journal.pone.0217271

Cited by 3 publications

(8 citation statements)

References 33 publications

(33 reference statements)

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“…MR imaging, tissue collection, tissue processing, and image registration procedures have been described in detail elsewhere (Moerman et al, 2019). In short, we imaged the carotid bifurcations of 11 patients scheduled for carotid endarterectomy (CEA) surgery in a 3.0-T MRI scanner (GE Healthcare, Milwaukee, United States).…”

Section: Mr Imaging Tissue Collection and Histological Processingmentioning

confidence: 99%

“…Image registration was performed according to the methods we described previously (Moerman et al, 2019). In short, via a series of rigid and nonrigid image registrations and transformations, the in vivo MRI lumen and its corresponding WSS map were transformed consecutively to the ex vivo and the en face image domain.…”

Section: Image Registration Of Mri Cfd and Histologymentioning

confidence: 99%

“…In addition, studies of the carotid artery are often based on assumed WSS levels (Dirksen et al, 1998;Lovett and Rothwell, 2003;Fagerberg et al, 2010) or used animal models, which are not truly representative (Winkel et al, 2015;Daugherty et al, 2017). Since histology is the gold standard for the assessment of human plaque composition in high resolution, we previously developed a framework for accurate registration of MRI-derived WSS patterns to histological cross-sections (Moerman et al, 2019). In this study, we investigated the correlation between WSS and histologically identified components of plaque vulnerability in a dataset of advanced human carotid atherosclerotic plaques.…”

Section: Introductionmentioning

confidence: 99%

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The Correlation Between Wall Shear Stress and Plaque Composition in Advanced Human Carotid Atherosclerosis

Moerman

Korteland

Dilba

et al. 2022

Front. Bioeng. Biotechnol.

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The role of wall shear stress (WSS) in atherosclerotic plaque development is evident, but the relation between WSS and plaque composition in advanced atherosclerosis, potentially resulting in plaque destabilization, is a topic of discussion. Using our previously developed image registration pipeline, we investigated the relation between two WSS metrics, time-averaged WSS (TAWSS) and the oscillatory shear index (OSI), and the local histologically determined plaque composition in a set of advanced human carotid plaques. Our dataset of 11 carotid endarterectomy samples yielded 87 histological cross-sections, which yielded 511 radial bins for analysis. Both TAWSS and OSI values were subdivided into patient-specific low, mid, and high tertiles. This cross-sectional study shows that necrotic core (NC) size and macrophage area are significantly larger in areas exposed to high TAWSS or low OSI. Local TAWSS and OSI tertile values were generally inversely related, as described in the literature, but other combinations were also found. Investigating the relation between plaque vulnerability features and different combinations of TAWSS and OSI tertile values revealed a significantly larger cap thickness in areas exposed to both low TAWSS and low OSI. In conclusion, our study confirmed previous findings, correlating high TAWSS to larger macrophage areas and necrotic core sizes. In addition, our study demonstrated new relations, correlating low OSI to larger macrophage areas, and a combination of low TAWSS and low OSI to larger cap thickness.

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Section: Mr Imaging Tissue Collection and Histological Processingmentioning

confidence: 99%

Section: Image Registration Of Mri Cfd and Histologymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Correlation Between Wall Shear Stress and Plaque Composition in Advanced Human Carotid Atherosclerosis

Moerman

Korteland

Dilba

et al. 2022

Front. Bioeng. Biotechnol.

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“…Wang et al [ 22 ] conducted animal experiments using positive and negative contrast agents to map ischemic regions in MRI. Moerman et al [ 23 ] performed a combined analysis with histology sections and WSS to find the correlation between WSS and plaque thickness. Similar to Moerman et al’s combined analysis, we conducted the combined analysis of SNAP sequences and WSS data.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Plaque Vulnerability via Combination of Hemodynamic Analysis and Simultaneous Non-Contrast Angiography and Intraplaque Hemorrhage (SNAP) Sequence for Carotid Intraplaque Hemorrhage

Lee

Kwak

2021

JPM

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The purpose of this study was to assess the vulnerability of plaque using a combination of simultaneous non-contrast angiography, intraplaque hemorrhage (SNAP) sequence, and local hemodynamic analysis in an intraplaque hemorrhage (IPH), and to evaluate the association between morphological and hemodynamic factors and IPH by comparing the IPH (presence of IPH) and non-IPH (plaque with absence of IPH) groups. In total, 27 IPH patients and 27 non-IPH patients were involved in this study, and baseline characteristics were collected. For morphological factors, diameters, and areas of the internal carotid artery (ICA), external carotid artery, and common carotid artery were measured, and bifurcation angle (α) and ICA angle (β) were also measured for comparison between the IPH group and non-IPH group. For hemodynamic factors, time-averaged wall shear stress (WSS), minimum WSS, maximum WSS, and oscillatory shear index were calculated using computational fluid dynamics (CFD) simulations. For the qualitative analysis, cross-sectional images with analyzed WSS and SNAP sequences were combined to precisely assess local hemodynamics. Bifurcation angle (α) was significantly different between the IPH and non-IPH groups (39.47 degrees vs. 47.60 degrees, p = 0.041). Significantly higher time-averaged WSS, minimum WSS, and maximum WSS were observed in the IPH group compared to the non-IPH group. In the IPH group, when using the combined analysis with SNAP sequences and WSS, the WSS of the region with IPH was significantly higher than the region without IPH (2.32 vs. 1.21 Pa, p = 0.005). A smaller bifurcation angle (α) and higher time-averaged WSS, minimum WSS, and maximum WSS were associated with IPH. The combined analysis of SNAP sequences and WSS might help to evaluate the risk of carotid IPH.

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“…32 In a study published in 2017, based on 1,072 symptomatic subjects that underwent MRI of carotid arteries, the MWT was more strongly associated with cerebral ischemic symptoms (AUC=0.93; 95% confidence interval [CI]: 0.91-0.95) than was the degree of stenosis (AUC=0.81; 95% CI: 0.76-0.84). 33 The use of advanced techniques 34,35 in MR imaging allow to better define the carotid plaque with subsequent plaque thickness quantification.…”

Section: Carotid Artery Plaque Thickness and Lengthmentioning

confidence: 99%

CT and MR Imaging of Carotid Wall and Plaque

Saba

Mannelli

Balestrieri

et al. 2019

J Neurosonol Neuroimag

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Imaging of the carotid artery wall is the focus of several ongoing research studies that are investigating the optimal approach to identify so-called "vulnerable plaques". Even when standard arterial luminal imaging fails to indicate a stenosis in stroke patients, a non-stenotic plaque may be responsible for the stroke. Indeed, over the past decade there has been a paradigm shift in the diagnosis and risk stratification of patients with carotid artery disease, whereby nowadays more emphasis is put on plaque characterization, mainly by using computed tomography (CT) and magnetic resonance (MR), in addition to the usual assessment of stenosis and surface irregularities. In this review, we will discuss current state-of-the-art CT and MR techniques to characterize vulnerable plaques and summarize current developments in imaging-based assessment of carotid plaques, in order to identify ideal candidates for revascularization and to monitor the effects of medical therapy. JNN 116 http://www.j-nn.org J Neurosonol Neuroimag 2019;11(2):115-125 Luca Saba, et al. Imaging of Carotid Plaque ification and therapy selection in patients with both high-and low-degree carotid artery stenosis.and size of the lipid-rich-necrotic-core (LRNC), and active plaque inflammation. In the following sections the features linked to plaque vulnerability are presented. FIG. 4. Male patient with right hand weakness with ulceration in the (A) left internal carotid artery internal carotid artery visibile in the sagittal, (B) axial and (C) Coronal planes (white arrows).

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An MRI-based method to register patient-specific wall shear stress data to histology

Cited by 3 publications

References 33 publications

The Correlation Between Wall Shear Stress and Plaque Composition in Advanced Human Carotid Atherosclerosis

The Correlation Between Wall Shear Stress and Plaque Composition in Advanced Human Carotid Atherosclerosis

Evaluation of Plaque Vulnerability via Combination of Hemodynamic Analysis and Simultaneous Non-Contrast Angiography and Intraplaque Hemorrhage (SNAP) Sequence for Carotid Intraplaque Hemorrhage

CT and MR Imaging of Carotid Wall and Plaque

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