TY - JOUR
T1 - Quantification of carotid plaque composition with a multi-contrast atherosclerosis characterization (MATCH) MRI sequence
AU - Kassem, Mohamed
AU - Nies, Kelly P.H.
AU - Boswijk, Ellen
AU - van der Pol, Jochem
AU - Aizaz, Mueez
AU - Gijbels, Marion J.J.
AU - Li, Debiao
AU - Bucerius, Jan
AU - Mess, Werner H.
AU - Wildberger, Joachim E.
AU - van Oostenbrugge, Robert J.
AU - Moonen, Rik P.M.
AU - Fan, Zhaoyang
AU - Kooi, M. Eline
N1 - Funding Information:
MK is funded by a VidW grant (VidW.1154.18.02L7637). MA, JB, and EK have received funding from the European Union Horizon 2020 Research and Innovation Program under Marie Sklodowska-Curie grant agreement no. 722609 (INTRICARE). JB has received funding from the International Atomic Energy Agency (IAEA): The PIAF Trial.
Publisher Copyright:
2023 Kassem, Nies, Boswijk, van der Pol, Aizaz, Gijbels, Li, Bucerius, Mess, Wildberger, van Oostenbrugge, Moonen, Fan and Kooi.
PY - 2023/8/23
Y1 - 2023/8/23
N2 - Background and purpose: Carotid atherosclerotic plaques with a large lipid-rich necrotic core (LRNC), intraplaque hemorrhage (IPH), and a thin or ruptured fibrous cap are associated with increased stroke risk. Multi-sequence MRI can be used to quantify carotid atherosclerotic plaque composition. Yet, its clinical implementation is hampered by long scan times and image misregistration. Multi-contrast atherosclerosis characterization (MATCH) overcomes these limitations. This study aims to compare the quantification of plaque composition with MATCH and multi-sequence MRI. Methods: MATCH and multi-sequence MRI were used to image 54 carotid arteries of 27 symptomatic patients with =2 mm carotid plaque on a 3.0 T MRI scanner. The following sequence parameters for MATCH were used: repetition time/echo time (TR/TE), 10.1/4.35 ms; field of view, 160 mm × 160 mm × 2 mm; matrix size, 256 × 256; acquired in-plane resolution, 0.63 mm2× 0.63 mm2; number of slices, 18; and flip angles, 8°, 5°, and 10°. Multi-sequence MRI (black-blood pre- and post-contrast T1-weighted, time of flight, and magnetization prepared rapid acquisition gradient echo; acquired in-plane resolution: 0.63 mm2 × 0.63 mm2) was acquired according to consensus recommendations, and image quality was scored (5-point scale). The interobserver agreement in plaque composition quantification was assessed by the intraclass correlation coefficient (ICC). The sensitivity and specificity of MATCH in identifying plaque composition were calculated using multi-sequence MRI as a reference standard. Results: A significantly lower image quality of MATCH compared to that of multi-sequence MRI was observed (p < 0.05). The scan time for MATCH was shorter (7 vs. 40 min). Interobserver agreement in quantifying plaque composition on MATCH images was good to excellent (ICC = 0.77) except for the total volume of calcifications and fibrous tissue that showed moderate agreement (ICC = 0.61). The sensitivity and specificity of detecting plaque components on MATCH were =89% and =91% for IPH, =81% and 85% for LRNC, and =71% and =32% for calcifications, respectively. Overall, good-to-excellent agreement (ICC = 0.76) of quantifying plaque components on MATCH with multi-sequence MRI as the reference standard was observed except for calcifications (ICC = 0.37–0.38) and fibrous tissue (ICC = 0.59–0.70). Discussion and conclusion: MATCH images can be used to quantify plaque components such as LRNC and IPH but not for calcifications. Although MATCH images showed a lower mean image quality score, short scan time and inherent co-registration are significant advantages.
AB - Background and purpose: Carotid atherosclerotic plaques with a large lipid-rich necrotic core (LRNC), intraplaque hemorrhage (IPH), and a thin or ruptured fibrous cap are associated with increased stroke risk. Multi-sequence MRI can be used to quantify carotid atherosclerotic plaque composition. Yet, its clinical implementation is hampered by long scan times and image misregistration. Multi-contrast atherosclerosis characterization (MATCH) overcomes these limitations. This study aims to compare the quantification of plaque composition with MATCH and multi-sequence MRI. Methods: MATCH and multi-sequence MRI were used to image 54 carotid arteries of 27 symptomatic patients with =2 mm carotid plaque on a 3.0 T MRI scanner. The following sequence parameters for MATCH were used: repetition time/echo time (TR/TE), 10.1/4.35 ms; field of view, 160 mm × 160 mm × 2 mm; matrix size, 256 × 256; acquired in-plane resolution, 0.63 mm2× 0.63 mm2; number of slices, 18; and flip angles, 8°, 5°, and 10°. Multi-sequence MRI (black-blood pre- and post-contrast T1-weighted, time of flight, and magnetization prepared rapid acquisition gradient echo; acquired in-plane resolution: 0.63 mm2 × 0.63 mm2) was acquired according to consensus recommendations, and image quality was scored (5-point scale). The interobserver agreement in plaque composition quantification was assessed by the intraclass correlation coefficient (ICC). The sensitivity and specificity of MATCH in identifying plaque composition were calculated using multi-sequence MRI as a reference standard. Results: A significantly lower image quality of MATCH compared to that of multi-sequence MRI was observed (p < 0.05). The scan time for MATCH was shorter (7 vs. 40 min). Interobserver agreement in quantifying plaque composition on MATCH images was good to excellent (ICC = 0.77) except for the total volume of calcifications and fibrous tissue that showed moderate agreement (ICC = 0.61). The sensitivity and specificity of detecting plaque components on MATCH were =89% and =91% for IPH, =81% and 85% for LRNC, and =71% and =32% for calcifications, respectively. Overall, good-to-excellent agreement (ICC = 0.76) of quantifying plaque components on MATCH with multi-sequence MRI as the reference standard was observed except for calcifications (ICC = 0.37–0.38) and fibrous tissue (ICC = 0.59–0.70). Discussion and conclusion: MATCH images can be used to quantify plaque components such as LRNC and IPH but not for calcifications. Although MATCH images showed a lower mean image quality score, short scan time and inherent co-registration are significant advantages.
KW - atherosclerotic plaque
KW - carotid arteries
KW - magnetic resonance imaging
KW - MATCH
KW - MATCH MRI sequence for quantifying carotid plaque composition
KW - stroke
U2 - 10.3389/fcvm.2023.1227495
DO - 10.3389/fcvm.2023.1227495
M3 - Article
SN - 2297-055X
VL - 10
JO - Frontiers in Cardiovascular Medicine
JF - Frontiers in Cardiovascular Medicine
M1 - 1227495
ER -