Quantitative assessment of carotid plaque morphology (geometry and tissue composition) using computed tomography angiography

Chrencik, Matthew T.; Khan, Amir; Luther, Lauren; Anthony, Laila; Yokemick, John; Patel, Jigar B.; Sorkin, John D.; Sikdar, Siddhartha; Lal, Brajesh K.

doi:10.1016/j.jvs.2018.11.050

Cited by 33 publications

(20 citation statements)

References 49 publications

(45 reference statements)

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“…13,14,27,28 The introduction of a new CT criterion ( 25 HU of attenuation) for the detection of IPH applied to the use of volumetric quantification analysis systems could allow one to extrapolate the real impact of the IPH component. Recently published articles in 2019 29,30 have demonstrated that the volumetric analysis of the carotid artery plaques obtained by CT data is a reliable technique and that small changes in plaque composition can also be detected. 30 In past years, the classic division of the carotid artery plaque type according to the attenuation values was based on the seminal study by de Weert et al, 24 in which 3 classes were identified: lipid (<60 HU), mixed (between 60 and 130 HU), and calcified (>130 HU).…”

Section: Discussionmentioning

confidence: 99%

“…Recently published articles in 2019 29,30 have demonstrated that the volumetric analysis of the carotid artery plaques obtained by CT data is a reliable technique and that small changes in plaque composition can also be detected. 30 In past years, the classic division of the carotid artery plaque type according to the attenuation values was based on the seminal study by de Weert et al, 24 in which 3 classes were identified: lipid (<60 HU), mixed (between 60 and 130 HU), and calcified (>130 HU). With the demonstration that attenuation values of <25 HU are due to IPH, 10 we tried to test the effect of the volumes for this component; therefore, the lipid class was divided into IPH (<25 HU) and lipid-IPH (from 26 to 59 HU).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Carotid Intraplaque-Hemorrhage Volume and Its Association with Cerebrovascular Events

Saba¹,

Micheletti²,

Brinjikji

et al. 2019

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Our aim was to assess the relationship between volume and percentage of intraplaque hemorrhage measured using CT and the occurrence of cerebrovascular events at the time of CT. MATERIALS AND METHODS: One-hundred-twenty-three consecutive subjects (246 carotid arteries) with a mean age of 69 years who underwent CTA were included in this retrospective study. Plaque volume of components and subcomponents (including intraplaque hemorrhage volume) was quantified with dedicated software.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Carotid Intraplaque-Hemorrhage Volume and Its Association with Cerebrovascular Events

Saba¹,

Micheletti²,

Brinjikji

et al. 2019

AJNR Am J Neuroradiol

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“…Carotid plaques were assessed in pre-operative CT angiographies using a semi-automated, histology-validated software as previously described (The vascuCAP ® (Elucid Bioimaging Inc., Boston, MA, USA) software) [ 36 , 37 , 38 , 39 , 40 , 41 ]. In brief, reconstructed images were analyzed in a blinded fashion by one observer (EK) to characterize plaque structure and composition (plaque morphology) [ 4 ] creating 3D segmentations with improved resolution and soft tissue plaque component differentiation.…”

Section: Methodsmentioning

confidence: 99%

Proteoglycan 4 Modulates Osteogenic Smooth Muscle Cell Differentiation during Vascular Remodeling and Intimal Calcification

Seime

Akbulut

Liljeqvist

et al. 2021

Cells

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Calcification is a prominent feature of late-stage atherosclerosis, but the mechanisms driving this process are unclear. Using a biobank of carotid endarterectomies, we recently showed that Proteoglycan 4 (PRG4) is a key molecular signature of calcified plaques, expressed in smooth muscle cell (SMC) rich regions. Here, we aimed to unravel the PRG4 role in vascular remodeling and intimal calcification. PRG4 expression in human carotid endarterectomies correlated with calcification assessed by preoperative computed tomographies. PRG4 localized to SMCs in early intimal thickening, while in advanced lesions it was found in the extracellular matrix, surrounding macro‑calcifications. In experimental models, Prg4 was upregulated in SMCs from partially ligated ApoE−/− mice and rat carotid intimal hyperplasia, correlating with osteogenic markers and TGFb1. Furthermore, PRG4 was enriched in cells positive for chondrogenic marker SOX9 and around plaque calcifications in ApoE−/− mice on warfarin. In vitro, PRG4 was induced in SMCs by IFNg, TGFb1 and calcifying medium, while SMC markers were repressed under calcifying conditions. Silencing experiments showed that PRG4 expression was driven by transcription factors SMAD3 and SOX9. Functionally, the addition of recombinant human PRG4 increased ectopic SMC calcification, while arresting cell migration and proliferation. Mechanistically, it suppressed endogenous PRG4, SMAD3 and SOX9, and restored SMC markers’ expression. PRG4 modulates SMC function and osteogenic phenotype during intimal remodeling and macro-calcification in response to TGFb1 signaling, SMAD3 and SOX9 activation. The effects of PRG4 on SMC phenotype and calcification suggest its role in atherosclerotic plaque stability, warranting further investigations.

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“…In the study of carotid plaque, it is important to consider that the contribution of different features to the occurrence of cerebrovascular events varies greatly. Some morphological, biomechanical, and pathological features are thought to be related to plaque progression (Takaya et al, 2006;Chrencik et al, 2019;Wang et al, 2019). First of all, morphological and biomechanical features such as plaque area and plaque burden can be used to predict the progression of plaque and have been proved more accurate than a single risk factor (Wang et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

“…First of all, morphological and biomechanical features such as plaque area and plaque burden can be used to predict the progression of plaque and have been proved more accurate than a single risk factor (Wang et al, 2019). In addition, little change in plaque geometry and quantitative analysis of pathological tissue composition is useful to track plaque progression or regression and the assessment of the risk of plaque rupture (Sheahan et al, 2018;Chrencik et al, 2019;Lu et al, 2019). More recently, studies have suggested that plaque progression may also be related largely to hemodynamics (Eshtehardi et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

The Differentiation in Image Post-processing and 3D Reconstruction During Evaluation of Carotid Plaques From MR and CT Data Sources

Deng

Yang

et al. 2021

Front. Physiol.

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Background: Carotid plaque morphology and tissue composition help assess risk stratification of stroke events. Many post-processing image techniques based on CT and MR images have been widely used in related research, such as image segmentation, 3D reconstruction, and computer fluid dynamics. However, the criteria for the 3D numerical model of carotid plaque established by CT and MR angiographic image data remain open to questioning.Method: We accurately duplicated the geometry and simulated it using computer software to make a 3D numerical model. The initial images were obtained by CTA and TOF-MRA. MIMICS (Materialize’s interactive medical image control system) software was used to process the images to generate three-dimensional solid models of blood vessels and plaques. The subsequent output was exported to the ANSYS software to generate finite element simulation results for the further hemodynamic study.Results: The 3D models of carotid plaque of TOF-MRA and CTA were simulated by using computer software. CTA has a high-density resolution for carotid plaque, the boundary of the CTA image is obvious, and the main component of which is a calcified tissue. However, the density resolution of TOF-MRA for the carotid plaque and carotid artery was not as good as that of CTA. The results show that there is a large deviation between the TOF-MRA and CTA 3D model of plaque in the carotid artery due to the unclear recognition of plaque boundary during 3D reconstruction, and this can further affect the simulation results of hemodynamics.Conclusion: In this study, two-dimensional images and three-dimensional models of carotid plaques obtained by two angiographic techniques were compared. The potential of these two imaging methods in clinical diagnosis and fluid dynamics of carotid plaque was evaluated, and the selectivity of image post-processing analysis to original medical image acquisition was revealed.

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Quantitative assessment of carotid plaque morphology (geometry and tissue composition) using computed tomography angiography

Cited by 33 publications

References 49 publications

Carotid Intraplaque-Hemorrhage Volume and Its Association with Cerebrovascular Events

Carotid Intraplaque-Hemorrhage Volume and Its Association with Cerebrovascular Events

Proteoglycan 4 Modulates Osteogenic Smooth Muscle Cell Differentiation during Vascular Remodeling and Intimal Calcification

The Differentiation in Image Post-processing and 3D Reconstruction During Evaluation of Carotid Plaques From MR and CT Data Sources

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