TY - JOUR
T1 - Components of carotid atherosclerotic plaque in spectral photon-counting CT with histopathologic comparison
AU - Dahal, Shishir
AU - Raja, Aamir Y.
AU - Searle, Emily
AU - Colgan, Frances E.
AU - Crighton, Jonathan S.
AU - Roake, Justin
AU - Saba, Luca
AU - Gieseg, Steven
AU - Butler, Anthony P.H.
N1 - Funding Information:
The authors acknowledge the University of Otago, University of Canterbury, European Council for Nuclear Research (CERN).
Funding Information:
This project was funded by the Ministry of Business, Innovation and Employment (MBIE), New Zealand under contract number UOCX1404, by MARS Bioimaging Ltd, and the Ministry of Education through the MedTech CoRE.
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to European Society of Radiology.
PY - 2023/3
Y1 - 2023/3
N2 - Objectives: This study aimed to demonstrate the effectiveness of spectral photon-counting CT (SPCCT) in quantifying fibrous cap (FC) thickness, FC area, and lipid-rich necrotic core (LRNC) area, in excised carotid atherosclerotic plaques by comparing it with histopathological measurements. Methods: This is a single-center ex vivo cross-sectional observational study. Excised plaques of 20 patients (71 +/- 6 years; 13 men), obtained from carotid endarterectomy were scanned with SPCCT using standardized acquisition settings (120k Vp/19 μA; 7–18 keV, 18–30 keV, 30–45 keV, 45–75 keV, and 75–118 keV). FC thickness, FC area, and LRNC area were quantified and compared between high-resolution 3D multi-energy CT images and histopathology using the Wilcoxon signed-ranks test and Bland–Altman analysis. Images were interpreted twice by two radiologists separately, blinded to the histopathology; inter- and intra-rater reliability were assessed with the intra-class correlation coefficients (ICC). Results: FC thickness and FC area did not show significant differences between the SPCCT-derived radiological measurements versus the histopathological measurements (p value range 0.15–0.51 for FC thickness and 0.053–0.30 for FC area). For the LRNC area, the p value was statistically non-significant for reader 1 (range 0.36–0.81). The Bland-Altman analysis showed mean difference and 95% confidence interval for FC thickness, FC area, and LRNC area, 0.04 (−0.36 to 0.12) square root mm, −0.18 (−0.34 to −0.02) log10 mm2 and 0.10 (−0.088. to 0.009) log10 mm2 respectively. Conclusion: The result demonstrated a viable technique for quantifying FC thickness, FC area, and LRNC area due to the combined effect of high spatial and energy resolution of SPCCT. Key Points: • SPCCT can identify and quantify different components of carotid atherosclerotic plaque in ex vivo study. • Components of atherosclerotic plaque did not show significant differences between the SPCCT-derived radiological measurements versus the histopathological measurements.
AB - Objectives: This study aimed to demonstrate the effectiveness of spectral photon-counting CT (SPCCT) in quantifying fibrous cap (FC) thickness, FC area, and lipid-rich necrotic core (LRNC) area, in excised carotid atherosclerotic plaques by comparing it with histopathological measurements. Methods: This is a single-center ex vivo cross-sectional observational study. Excised plaques of 20 patients (71 +/- 6 years; 13 men), obtained from carotid endarterectomy were scanned with SPCCT using standardized acquisition settings (120k Vp/19 μA; 7–18 keV, 18–30 keV, 30–45 keV, 45–75 keV, and 75–118 keV). FC thickness, FC area, and LRNC area were quantified and compared between high-resolution 3D multi-energy CT images and histopathology using the Wilcoxon signed-ranks test and Bland–Altman analysis. Images were interpreted twice by two radiologists separately, blinded to the histopathology; inter- and intra-rater reliability were assessed with the intra-class correlation coefficients (ICC). Results: FC thickness and FC area did not show significant differences between the SPCCT-derived radiological measurements versus the histopathological measurements (p value range 0.15–0.51 for FC thickness and 0.053–0.30 for FC area). For the LRNC area, the p value was statistically non-significant for reader 1 (range 0.36–0.81). The Bland-Altman analysis showed mean difference and 95% confidence interval for FC thickness, FC area, and LRNC area, 0.04 (−0.36 to 0.12) square root mm, −0.18 (−0.34 to −0.02) log10 mm2 and 0.10 (−0.088. to 0.009) log10 mm2 respectively. Conclusion: The result demonstrated a viable technique for quantifying FC thickness, FC area, and LRNC area due to the combined effect of high spatial and energy resolution of SPCCT. Key Points: • SPCCT can identify and quantify different components of carotid atherosclerotic plaque in ex vivo study. • Components of atherosclerotic plaque did not show significant differences between the SPCCT-derived radiological measurements versus the histopathological measurements.
KW - Endarterectomy, carotid
KW - Human
KW - Plaque, atherosclerotic
KW - Reproducibility of studies
KW - Tomography, X-ray computed
UR - http://www.scopus.com/inward/record.url?scp=85139500934&partnerID=8YFLogxK
U2 - 10.1007/s00330-022-09155-x
DO - 10.1007/s00330-022-09155-x
M3 - Article
C2 - 36205768
AN - SCOPUS:85139500934
SN - 0938-7994
VL - 33
SP - 1612
EP - 1619
JO - European Radiology
JF - European Radiology
IS - 3
ER -