Scan-rescan reproducibility of quantitative assessment of inflammatory carotid atherosclerotic plaque using dynamic contrast-enhanced 3T CMR in a multi-center study
Tóm tắt
The aim of this study is to investigate the inter-scan reproducibility of kinetic parameters in atherosclerotic plaque using dynamic contrast-enhanced (DCE) cardiovascular magnetic resonance (CMR) in a multi-center setting at 3T. Carotid arteries of 51 subjects from 15 sites were scanned twice within two weeks on 3T scanners using a previously described DCE-CMR protocol. Imaging data with protocol compliance and sufficient image quality were analyzed to generate kinetic parameters of vessel wall, expressed as transfer constant (K
trans
) and plasma volume (v
p
). The inter-scan reproducibility was evaluated using intra-class correlation coefficient (ICC) and coefficient of variation (CV). Power analysis was carried out to provide sample size estimations for future prospective study. Ten (19.6%) subjects were found to suffer from protocol violation, and another 6 (11.8%) had poor image quality (n = 6) in at least one scan. In the 35 (68.6%) subjects with complete data, the ICCs of K
trans
and v
p
were 0.65 and 0.28, respectively. The CVs were 25% and 62%, respectively. The ICC and CV for v
p
improved to 0.73 and 28% in larger lesions with analyzed area larger than 25 mm2. Power analysis based on the measured CV showed that 50 subjects per arm are sufficient to detect a 20% difference in change of K
trans
over time between treatment arms with 80% power without consideration of the dropout rate. The result of this study indicates that quantitative measurement from DCE-CMR is feasible to detect changes with a relatively modest sample size in a prospective multi-center study despite the limitations. The relative high dropout rate suggested the critical needs for intensive operator training, optimized imaging protocol, and strict quality control in future studies.
Tài liệu tham khảo
Libby P: Inflammation in atherosclerosis. Nature. 2002, 420 (6917): 868-74. 10.1038/nature01323.
Mofidi R, Crotty TB, McCarthy P, Sheehan SJ, Mehigan D, Keaveny TV: Association between plaque instability, angiogenesis and symptomatic carotid occlusive disease. Br J Surg. 2001, 88 (7): 945-50. 10.1046/j.0007-1323.2001.01823.x.
McCarthy MJ, Loftus IM, Thompson MM, Jones L, London NJ, Bell PR, Naylor AR, Brindle NP: Angiogenesis and the atherosclerotic carotid plaque: an association between symptomatology and plaque morphology. J Vasc Surg. 1999, 30 (2): 261-8. 10.1016/S0741-5214(99)70136-9.
Dunmore BJ, McCarthy MJ, Naylor AR, Brindle NP: Carotid plaque instability and ischemic symptoms are linked to immaturity of microvessels within plaques. J Vasc Surg. 2007, 45 (1): 155-9. 10.1016/j.jvs.2006.08.072.
Charo IF, Taub R: Anti-inflammatory therapeutics for the treatment of atherosclerosis. Nat Rev Drug Discov. 2011, 10 (5): 365-76. 10.1038/nrd3444.
Weber C, Noels H: Atherosclerosis: current pathogenesis and therapeutic options. Nat Med. 2011, 17 (11): 1410-22. 10.1038/nm.2538.
Kerwin W, Hooker A, Spilker M, Vicini P, Ferguson M, Hatsukami T, Yuan C: Quantitative magnetic resonance imaging analysis of neovasculature volume in carotid atherosclerotic plaque. Circulation. 2003, 107 (6): 851-6. 10.1161/01.CIR.0000048145.52309.31.
Kerwin W, O’Brien K, Ferguson M, Polissar N, Hatsukami T, Yuan C: Inflammation in carotid atherosclerotic plaque: a dynamic contrast-enhanced MR imaging study. Radiology. 2006, 241 (2): 459-68. 10.1148/radiol.2412051336.
Gaens ME, Backes WH, Rozel S, Lipperts M, Sanders SN, Jaspers K, Cleutjens JP, Sluimer JC, Heeneman S, Daemen MJ, Welten RJ, Daemen JW, Wildberger JE, Kwee RM, Kooi ME: Dynamic contrast-enhanced MR imaging of carotid atherosclerotic plaque: model selection, reproducibility, and validation. Radiology. 2013, 266 (1): 271-9. 10.1148/radiol.12120499.
Dong L, Kerwin WS, Chen H, Chu B, Underhill HR, Neradilek MB, Hatsukami TS, Yuan C, Zhao XQ: Carotid artery atherosclerosis: effect of intensive lipid therapy on the vasa vasorum–evaluation by using dynamic contrast-enhanced MR imaging. Radiology. 2011, 260 (1): 224-31. 10.1148/radiol.11101264.
Vucic E, Dickson SD, Calcagno C, Rudd JH, Moshier E, Hayashi K, Mounessa JS, Roytman M, Moon MJ, Lin J, Tsimikas S, Fisher EA, Nicolay K, Fuster V, Fayad ZA: Pioglitazone modulates vascular inflammation in atherosclerotic rabbits noninvasive assessment with FDG-PET-CT and dynamic contrast-enhanced MR imaging. JACC Cardiovasc Imaging. 2011, 4 (10): 1100-9. 10.1016/j.jcmg.2011.04.020.
Chen H, Ricks J, Rosenfeld M, Kerwin WS: Progression of experimental lesions of atherosclerosis: assessment by kinetic modeling of black-blood dynamic contrast-enhanced MRI. Magn Reson Med. 2013, 69 (6): 1712-20. 10.1002/mrm.24415.
Boden WE, Probstfield JL, Anderson T, Chaitman BR, Desvignes-Nickens P, Koprowicz K, McBride R, Teo K, Weintraub W, Investigators A-H: Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy. N Engl J Med. 2011, 365 (24): 2255-67. 10.1056/NEJMoa1107579.
Wang J, Liu H, Sun J, Xue H, Xie L, Yu S, Liang C, Han X, Guan Z, Wei L, Yuan C, Zhao X, Chen H: Varying Correlation Between 18F-Fluorodeoxyglucose Positron Emission Tomography and Dynamic Contrast-Enhanced MRI in Carotid Atherosclerosis: Implications for Plaque Inflammation. Stroke. 2014, 45 (6): 1842-5. 10.1161/STROKEAHA.114.005147.
Kerwin W, Xu D, Liu F, Saam T, Underhill H, Takaya N, Chu B, Hatsukami T, Yuan C: Magnetic resonance imaging of carotid atherosclerosis: plaque analysis. Top Magn Reson Imaging. 2007, 18 (5): 371-8. 10.1097/rmr.0b013e3181598d9d.
Kerwin W, Oikawa M, Yuan C, Jarvik G, Hatsukami T: MR imaging of adventitial vasa vasorum in carotid atherosclerosis. Magn Reson Med. 2008, 59 (3): 507-14. 10.1002/mrm.21532.
Patlak C, Blasberg R, Fenstermacher J: Graphical evaluation of blood-to-brain transfer constants from multiple-time uptake data. J Cereb Blood Flow Metab. 1983, 3 (1): 1-7. 10.1038/jcbfm.1983.1.
Sun J, Song Y, Chen H, Kerwin WS, Hippe DS, Dong L, Chen M, Zhou C, Hatsukami TS, Yuan C: Adventitial perfusion and intraplaque hemorrhage: a dynamic contrast-enhanced MRI study in the carotid artery. Stroke. 2013, 44 (4): 1031-6. 10.1161/STROKEAHA.111.000435.
Grothues F, Smith GC, Moon JC, Bellenger NG, Collins P, Klein HU, Pennell DJ: Comparison of interstudy reproducibility of cardiovascular magnetic resonance with two-dimensional echocardiography in normal subjects and in patients with heart failure or left ventricular hypertrophy. Am J Cardiol. 2002, 90 (1): 29-34. 10.1016/S0002-9149(02)02381-0.
Saam T, Kerwin WS, Chu B, Cai J, Kampschulte A, Hatsukami TS, Zhao XQ, Polissar NL, Neradilek B, Yarnykh VL, Flemming K, Huston J, Insull W, Morrisett JD, Rand SD, DeMarco KJ, Yuan C: Sample size calculation for clinical trials using magnetic resonance imaging for the quantitative assessment of carotid atherosclerosis. J Cardiovasc Magn Reson. 2005, 7 (5): 799-808. 10.1080/10976640500287703.
Morton G, Schuster A, Jogiya R, Kutty S, Beerbaum P, Nagel E: Inter-study reproducibility of cardiovascular magnetic resonance myocardial feature tracking. J Cardiovasc Magn Reson. 2012, 14: 43-10.1186/1532-429X-14-43.
Chen H, Li F, Zhao X, Yuan C, Rutt B, Kerwin WS: Extended graphical model for analysis of dynamic contrast-enhanced MRI. Magn Reson Med. 2011, 66 (3): 868-78. 10.1002/mrm.22819.
Boussel L, Arora S, Rapp J, Rutt B, Huston J, Parker D, Yuan C, Bassiouny H, Saloner D, Investigators M: Atherosclerotic plaque progression in carotid arteries: monitoring with high-spatial-resolution MR imaging–multicenter trial. Radiology. 2009, 252 (3): 789-96. 10.1148/radiol.2523081798.
Calcagno C, Cornily J, Hyafil F, Rudd J, Briley-Saebo K, Mani V, Goldschlager G, Machac J, Fuster V, Fayad Z: Detection of neovessels in atherosclerotic plaques of rabbits using dynamic contrast enhanced MRI and 18 F-FDG PET. Arterioscler Thromb Vasc Biol. 2008, 28 (7): 1311-7. 10.1161/ATVBAHA.108.166173.