Purpose: To investigate direct volumetric in vivo correspondence of calcified atherosclerotic plaque lesions in MRI and CT images of the thoracic aorta by multimodality image registration and fusion.
Materials and Methods:Twelve CT (11 noncontrast and one contrast) and MRI (TruFISP, contrast T1-weighted volumetric interpolated breath-hold examination (VIBE)) data sets were coregistered by approximate segmentation of the aorta and subsequent automatic coregistration by maximization of mutual information (MI). We quantitatively assessed 22 coregistered calcified plaque lesions on CT and MRI.
Results:The three-dimensional registration consistency and accuracy were 1.74 Ϯ 1.3 mm, and 2.42 Ϯ 1.65 mm, respectively. The ratio of CT/MRI calcified plaque volume decreased asymptotically with MRI volume, and correlated with average CT lesion density (r ϭ 0.72) for small lesions (Ͻ25 mm 3 ). The average calcified plaque volume, circumferential extent, and maximal radial width by MRI were significantly smaller compared to CT (35%, 68%, and 53%, respectively; P Ͻ 0.05).
Conclusion:Software coregistration allowed precise, direct, and voxel-based comparison of calcified atherosclerotic plaque lesions imaged by MRI and CT. In comparison with coregistered MRI, overestimation of calcified plaque in aortic CT due to "blooming" correlates with the average lesion density for small plaques, and is greater for small plaques. THE RISK OF ATHEROSCLEROTIC plaque disruption and subsequent thrombosis or coronary occlusion makes atherosclerosis a potentially life-threatening disease (1). The presence of atherosclerotic plaque in the thoracic aorta has been shown to correlate with obstructive coronary artery disease (2-4). Computed tomography (CT) and magnetic resonance imaging (MRI) are promising, noninvasive imaging modalities for the detection and assessment of atherosclerotic plaque (5). Noncontrast CT is well established for assessment of calcified plaque, which has been shown to be correlated with the overall plaque burden (6,7). MRI also allows characterization of atherosclerotic plaque composition (5). These two complementary modalities, when assessed together, may provide unique information regarding patient risk assessment and response to therapy (5). However, when both MRI and CT images are available, comparative assessment is typically performed by manually displaying each series at approximately the same location in a side-by-side fashion. To our knowledge, no prior study has performed a direct, volumetric, voxel-by-voxel comparison of plaque lesions by MRI and CT. One of the prerequisites for such a volumetric comparison is the precise and robust coregistration of MRI and CT.In this study our goal was to investigate direct volumetric in vivo correspondence of calcified plaque lesions of the thoracic aorta imaged by MRI and CT. For this purpose we developed and evaluated a semiautomatic method for precise coregistration and fusion of CT and three-dimensional (3D) MRI images of the aorta. We also developed new methods for quantify...