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Chan K, Maralani PJ, Moody AR, Khademi A. Synthesis of diffusion-weighted MRI scalar maps from FLAIR volumes using generative adversarial networks. Front Neuroinform 2023; 17:1197330. [PMID: 37603783 PMCID: PMC10436214 DOI: 10.3389/fninf.2023.1197330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 07/18/2023] [Indexed: 08/23/2023] Open
Abstract
Introduction Acquisition and pre-processing pipelines for diffusion-weighted imaging (DWI) volumes are resource- and time-consuming. Generating synthetic DWI scalar maps from commonly acquired brain MRI sequences such as fluid-attenuated inversion recovery (FLAIR) could be useful for supplementing datasets. In this work we design and compare GAN-based image translation models for generating DWI scalar maps from FLAIR MRI for the first time. Methods We evaluate a pix2pix model, two modified CycleGANs using paired and unpaired data, and a convolutional autoencoder in synthesizing DWI fractional anisotropy (FA) and mean diffusivity (MD) from whole FLAIR volumes. In total, 420 FLAIR and DWI volumes (11,957 images) from multi-center dementia and vascular disease cohorts were used for training/testing. Generated images were evaluated using two groups of metrics: (1) human perception metrics including peak signal-to-noise ratio (PSNR) and structural similarity (SSIM), (2) structural metrics including a newly proposed histogram similarity (Hist-KL) metric and mean squared error (MSE). Results Pix2pix demonstrated the best performance both quantitatively and qualitatively with mean PSNR, SSIM, and MSE metrics of 23.41 dB, 0.8, 0.004, respectively for MD generation, and 24.05 dB, 0.78, 0.004, respectively for FA generation. The new histogram similarity metric demonstrated sensitivity to differences in fine details between generated and real images with mean pix2pix MD and FA Hist-KL metrics of 11.73 and 3.74, respectively. Detailed analysis of clinically relevant regions of white matter (WM) and gray matter (GM) in the pix2pix images also showed strong significant (p < 0.001) correlations between real and synthetic FA values in both tissue types (R = 0.714 for GM, R = 0.877 for WM). Discussion/conclusion Our results show that pix2pix's FA and MD models had significantly better structural similarity of tissue structures and fine details than other models, including WM tracts and CSF spaces, between real and generated images. Regional analysis of synthetic volumes showed that synthetic DWI images can not only be used to supplement clinical datasets, but demonstrates potential utility in bypassing or correcting registration in data pre-processing.
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Affiliation(s)
- Karissa Chan
- Electrical, Computer and Biomedical Engineering Department, Toronto Metropolitan University, Toronto, ON, Canada
- Institute of Biomedical Engineering, Science and Technology (iBEST), Toronto, ON, Canada
| | - Pejman Jabehdar Maralani
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Alan R. Moody
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - April Khademi
- Electrical, Computer and Biomedical Engineering Department, Toronto Metropolitan University, Toronto, ON, Canada
- Institute of Biomedical Engineering, Science and Technology (iBEST), Toronto, ON, Canada
- Keenan Research Center, St. Michael’s Hospital, Toronto, ON, Canada
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Gibicar A, Moody AR, Khademi A. Automated Midline Estimation for Symmetry Analysis of Cerebral Hemispheres in FLAIR MRI. Front Aging Neurosci 2021; 13:644137. [PMID: 33994994 PMCID: PMC8118126 DOI: 10.3389/fnagi.2021.644137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/24/2021] [Indexed: 01/09/2023] Open
Abstract
To perform brain asymmetry studies in large neuroimaging archives, reliable and automatic detection of the interhemispheric fissure (IF) is needed to first extract the cerebral hemispheres. The detection of the IF is often referred to as mid-sagittal plane estimation, as this plane separates the two cerebral hemispheres. However, traditional planar estimation techniques fail when the IF presents a curvature caused by existing pathology or a natural phenomenon known as brain torque. As a result, midline estimates can be inaccurate. In this study, a fully unsupervised midline estimation technique is proposed that is comprised of three main stages: head angle correction, control point estimation and midline generation. The control points are estimated using a combination of intensity, texture, gradient, and symmetry-based features. As shown, the proposed method automatically adapts to IF curvature, is applied on a slice-to-slice basis for more accurate results and also provides accurate delineation of the midline in the septum pellucidum, which is a source of failure for traditional approaches. The method is compared to two state-of-the-art methods for midline estimation and is validated using 75 imaging volumes (~3,000 imaging slices) acquired from 38 centers of subjects with dementia and vascular disease. The proposed method yields the lowest average error across all metrics: Hausdorff distance (HD) was 0.32 ± 0.23, mean absolute difference (MAD) was 1.10 ± 0.38 mm and volume difference was 7.52 ± 5.40 and 5.35 ± 3.97 ml, for left and right hemispheres, respectively. Using the proposed method, the midline was extracted for 5,360 volumes (~275K images) from 83 centers worldwide, acquired by GE, Siemens and Philips scanners. An asymmetry index was proposed that automatically detected outlier segmentations (which were <1% of the total dataset). Using the extracted hemispheres, hemispheric asymmetry texture biomarkers of the normal-appearing brain matter (NABM) were analyzed in a dementia cohort, and significant differences in biomarker means were found across SCI and MCI and SCI and AD.
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Affiliation(s)
- Adam Gibicar
- Electrical, Computer and Biomedical Engineering Department, Ryerson University, Toronto, ON, Canada
| | - Alan R Moody
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - April Khademi
- Electrical, Computer and Biomedical Engineering Department, Ryerson University, Toronto, ON, Canada.,Keenan Research Center for Biomedical Science, St. Michael's Hospital, Unity Health Network, Toronto, ON, Canada.,Institute for Biomedical Engineering, Science and Technology, A Partnership Between St. Michael's Hospital and Ryerson University, Toronto, ON, Canada
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DiGregorio J, Arezza G, Gibicar A, Moody AR, Tyrrell PN, Khademi A. Intracranial volume segmentation for neurodegenerative populations using multicentre FLAIR MRI. NEUROIMAGE: REPORTS 2021. [DOI: 10.1016/j.ynirp.2021.100006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Advances in Multimodality Carotid Plaque Imaging: AJR Expert Panel Narrative Review. AJR Am J Roentgenol 2021; 217:16-26. [PMID: 33438455 DOI: 10.2214/ajr.20.24869] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Contemporary imaging methods provide detailed visualization of carotid athero-sclerotic plaque, enabling a major evolution of in vivo carotid plaque imaging evaluation. The degree of luminal stenosis in the carotid artery bifurcation, as assessed by ultrasound, has historically served as the primary imaging feature for determining ischemic stroke risk and the potential need for surgery. However, stroke risk may be more strongly driven by the presence of specific characteristics of vulnerable plaque, as visualized on CT and MRI, than by traditional ultrasound-based assessment of luminal narrowing. This review highlights six promising imaging-based plaque characteristics that harbor unique information regarding plaque vulnerability: maximum plaque thickness and volume, calcification, ulceration, intraplaque hemorrhage, lipid-rich necrotic core, and thin or ruptured fibrous cap. Increasing evidence supports the association of these plaque characteristics with risk of ischemic stroke, although these characteristics have varying suitability for clinical implementation. Key aspects of CT and MRI protocols for carotid plaque imaging are also considered. Practical next steps and hurdles are explored for implementing routine imaging assessment of these plaque characteristics in addition to, or even as replacement for, traditional assessment of the degree of vascular stenosis on ultrasound, in the identification of individuals at high risk of ischemic stroke.
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5
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Zhou R, Guo F, Azarpazhooh MR, Spence JD, Ukwatta E, Ding M, Fenster A. A Voxel-Based Fully Convolution Network and Continuous Max-Flow for Carotid Vessel-Wall-Volume Segmentation From 3D Ultrasound Images. IEEE TRANSACTIONS ON MEDICAL IMAGING 2020; 39:2844-2855. [PMID: 32142426 DOI: 10.1109/tmi.2020.2975231] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Vessel-wall-volume (VWV) is an important three-dimensional ultrasound (3DUS) metric used in the assessment of carotid plaque burden and monitoring changes in carotid atherosclerosis in response to medical treatment. To generate the VWV measurement, we proposed an approach that combined a voxel-based fully convolution network (Voxel-FCN) and a continuous max-flow module to automatically segment the carotid media-adventitia (MAB) and lumen-intima boundaries (LIB) from 3DUS images. Voxel-FCN includes an encoder consisting of a general 3D CNN and a 3D pyramid pooling module to extract spatial and contextual information, and a decoder using a concatenating module with an attention mechanism to fuse multi-level features extracted by the encoder. A continuous max-flow algorithm is used to improve the coarse segmentation provided by the Voxel-FCN. Using 1007 3DUS images, our approach yielded a Dice-similarity-coefficient (DSC) of 93.2±3.0% for the MAB in the common carotid artery (CCA), and 91.9±5.0% in the bifurcation by comparing algorithm and expert manual segmentations. We achieved a DSC of 89.5±6.7% and 89.3±6.8% for the LIB in the CCA and the bifurcation respectively. The mean errors between the algorithm-and manually-generated VWVs were 0.2±51.2 mm3 for the CCA and -4.0±98.2 mm3 for the bifurcation. The algorithm segmentation accuracy was comparable to intra-observer manual segmentation but our approach required less than 1s, which will not alter the clinical work-flow as 10s is required to image one side of the neck. Therefore, we believe that the proposed method could be used clinically for generating VWV to monitor progression and regression of carotid plaques.
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Bento M, Souza R, Salluzzi M, Rittner L, Zhang Y, Frayne R. Automatic identification of atherosclerosis subjects in a heterogeneous MR brain imaging data set. Magn Reson Imaging 2019; 62:18-27. [DOI: 10.1016/j.mri.2019.06.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 06/04/2019] [Accepted: 06/06/2019] [Indexed: 01/17/2023]
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Khademi A, Reiche B, DiGregorio J, Arezza G, Moody AR. Whole volume brain extraction for multi-centre, multi-disease FLAIR MRI datasets. Magn Reson Imaging 2019; 66:116-130. [PMID: 31472262 DOI: 10.1016/j.mri.2019.08.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 05/01/2019] [Accepted: 08/15/2019] [Indexed: 11/19/2022]
Abstract
Automatic segmentation of the brain from magnetic resonance images (MRI) is a fundamental step in many neuroimaging processing frameworks. There are mature technologies for this task for T1- and T2-weighted MRI; however, a widely-accepted brain extraction method for Fluid-Attenuated Inversion Recovery (FLAIR) MRI has yet to be established. FLAIR MRI are becoming increasingly important for the analysis of neurodegenerative diseases and tools developed for this sequence would have clinical value. To maximize translation opportunities and for large scale research studies, algorithms for brain extraction in FLAIR MRI should generalize to multi-centre (MC) data. To this end, this work proposes a fully automated, whole volume brain extraction methodology for MC FLAIR MRI datasets. The framework is built using a novel standardization framework which reduces acquisition artifacts, standardizes the intensities of tissues and normalizes the spatial coordinates of brain tissue across MC datasets. Using the standardized datasets, an intuitive set of features based on intensity, spatial location and gradients are extracted and classified using a random forest (RF) classifier to segment the brain tissue class. A series of experiments were conducted to optimize classifier parameters, and to determine segmentation accuracy for standardized and unstandardized (original) data, as a function of scanner vendor, feature type and disease type. The models are trained, tested and validated on 156 image volumes (∼8000 image slices) from two multi-centre, multi-disease datasets, acquired with varying imaging parameters from 30 centres and three scanner vendors. The image datasets, denoted as CAIN and ADNI for vascular and dementia disease, respectively, represent a diverse collection of MC data to test the generalization capabilities of the proposed design. Results demonstrate the importance of standardization for segmentation of MC data, as models trained on standardized data yielded a drastic improvement in brain extraction accuracy compared to the original, unstandardized data (CAIN: DSC = 91% and ADNI: DSC = 86% vs. CAIN: 78% and ADNI: 65%). It was also found that models created from one scanner vendor based on unstandardized data yielded poor segmentation results in data acquired from other scanner vendors, which was improved through standardization. These results demonstrate that to create consistency in segmentations from multi-institutional datasets it is paramount that MC variability be mitigated to improve stability and to ensure generalization of machine learning algorithms for MRI.
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Affiliation(s)
- April Khademi
- Image Analysis in Medicine Lab (IAMLAB), Department of Electrical, Computer and Biomedical Engineering, Ryerson University, Toronto, ON M5B 2K3, Canada.
| | | | - Justin DiGregorio
- Image Analysis in Medicine Lab (IAMLAB), Department of Electrical, Computer and Biomedical Engineering, Ryerson University, Toronto, ON M5B 2K3, Canada
| | - Giordano Arezza
- Image Analysis in Medicine Lab (IAMLAB), Department of Electrical, Computer and Biomedical Engineering, Ryerson University, Toronto, ON M5B 2K3, Canada
| | - Alan R Moody
- Department of Medical Imaging, University of Toronto, Toronto M5S 1A1, Canada
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Saba L, Saam T, Jäger HR, Yuan C, Hatsukami TS, Saloner D, Wasserman BA, Bonati LH, Wintermark M. Imaging biomarkers of vulnerable carotid plaques for stroke risk prediction and their potential clinical implications. Lancet Neurol 2019; 18:559-572. [PMID: 30954372 DOI: 10.1016/s1474-4422(19)30035-3] [Citation(s) in RCA: 270] [Impact Index Per Article: 54.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 01/03/2019] [Accepted: 01/04/2019] [Indexed: 01/15/2023]
Abstract
Stroke represents a massive public health problem. Carotid atherosclerosis plays a fundamental part in the occurence of ischaemic stroke. European and US guidelines for prevention of stroke in patients with carotid plaques are based on quantification of the percentage reduction in luminal diameter due to the atherosclerotic process to select the best therapeutic approach. However, better strategies for prevention of stroke are needed because some subtypes of carotid plaques (eg, vulnerable plaques) can predict the occurrence of stroke independent of the degree of stenosis. Advances in imaging techniques have enabled routine characterisation and detection of the features of carotid plaque vulnerability. Intraplaque haemorrhage is accepted by neurologists and radiologists as one of the features of vulnerable plaques, but other characteristics-eg, plaque volume, neovascularisation, and inflammation-are promising as biomarkers of carotid plaque vulnerability. These biomarkers could change current management strategies based merely on the degree of stenosis.
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Affiliation(s)
- Luca Saba
- Department of Medical Sciences, University of Cagliari, Cagliari, Italy.
| | - Tobias Saam
- Department of Radiology, University Hospital Munich, Ludwig-Maximilians-University Munich, Munich, Germany; Radiologisches Zentrum Rosenheim, Rosenheim, Germany
| | - H Rolf Jäger
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, University College London Institute of Neurology, London, UK
| | - Chun Yuan
- Department of Radiology, University of Washington, Seattle, WA, USA
| | | | - David Saloner
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Bruce A Wasserman
- The Russell H Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Leo H Bonati
- Department of Neurology and Stroke Center, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Max Wintermark
- Department of Radiology, Neuroradiology Division, Stanford University, Stanford, CA, USA
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9
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Role of inflammation in the pathogenesis of atherosclerosis and therapeutic interventions. Atherosclerosis 2018; 276:98-108. [DOI: 10.1016/j.atherosclerosis.2018.07.014] [Citation(s) in RCA: 197] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 07/03/2018] [Accepted: 07/11/2018] [Indexed: 12/15/2022]
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10
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Cocker MS, Spence JD, Hammond R, deKemp RA, Lum C, Wells G, Bernick J, Hill A, Nagpal S, Stotts G, Alturkustani M, Adeeko A, Yerofeyeva Y, Rayner K, Peterson J, Khan AR, Naidas AC, Garrard L, Yaffe MJ, Leung E, Prato FS, Tardif JC, Beanlands RSB. [18F]-Fluorodeoxyglucose PET/CT imaging as a marker of carotid plaque inflammation: Comparison to immunohistology and relationship to acuity of events. Int J Cardiol 2018; 271:378-386. [PMID: 30007487 DOI: 10.1016/j.ijcard.2018.05.057] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 05/02/2018] [Accepted: 05/17/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND [18F]-fluorodeoxyglucose (18FDG) uptake imaged with positron emission tomography (PET) and computed tomography (CT) may serve as a biomarker of plaque inflammation. This study evaluated the relationship between carotid plaque 18FDG uptake and a) intraplaque expression of macrophage and macrophage-like cellular CD68 immunohistology; b) intraplaque inflammatory burden using leukocyte-sensitive CD45 immunohistology; c) symptomatic patient presentation; d) time from last cerebrovascular event. METHODS 54 patients scheduled for carotid endarterectomy underwent 18FDG PET/CT imaging. Maximum 18FDG uptake (SUVmax) and tissue-to-blood ratio (TBRmax) was measured for carotid plaques. Quantitative immunohistological analysis of macrophage-like cell expression (CD68) and leukocyte content (CD45) was performed. RESULTS 18FDG uptake was related to CD68 macrophage expression (TBRmax: r = 0.51, p < 0.001), and total-plaque leukocyte CD45 expression (TBRmax: r = 0.632, p = 0.009, p < 0.001). 18FDG TBRmax uptake in carotid plaque associated with patient symptoms was greater than asymptomatic plaque (3.58 ± 1.01 vs. 3.13 ± 1.10, p = 0.008). 18FDG uptake differed between an acuity threshold of <90 days and >90 days (SUVmax:3.15 ± 0.87 vs. 2.52 ± 0.45, p = 0.015). CONCLUSIONS In this CAIN cohort, 18FDG uptake imaged with PET/CT serves a surrogate marker of intraplaque inflammatory macrophage, macrophage-like cell and leukocyte burden. 18FDG uptake is greater in plaque associated with patient symptoms and those with recent cerebrovascular events. Future studies are needed to relate 18FDG uptake and disease progression.
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Affiliation(s)
- Myra S Cocker
- Molecular Function and Imaging Program and the National Cardiac PET Centre, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
| | - J David Spence
- Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, Ontario, Canada.
| | - Robert Hammond
- Department of Pathology, Western University, London, Ontario, Canada.
| | - Robert A deKemp
- Molecular Function and Imaging Program and the National Cardiac PET Centre, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
| | - Cheemun Lum
- Department of Radiology, University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada.
| | - George Wells
- Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
| | - Jordan Bernick
- Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
| | - Andrew Hill
- Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
| | - Sudhir Nagpal
- Division of Vascular Surgery, Department of Surgery, University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada.
| | - Grant Stotts
- Division of Neurology, Department of Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada.
| | | | - Adebayo Adeeko
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
| | - Yulia Yerofeyeva
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
| | - Katey Rayner
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Ontario, Canada.
| | - Joan Peterson
- Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
| | - Ali R Khan
- Department of Medical Biophysics, Robarts Research Institute, Western University, London, Ontario, Canada.
| | - Ann C Naidas
- Department of Pathology, Western University, London, Ontario, Canada.
| | - Linda Garrard
- Molecular Function and Imaging Program and the National Cardiac PET Centre, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
| | - Martin J Yaffe
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
| | - Eugene Leung
- Division of Nuclear Medicine, Department of Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada.
| | - Frank S Prato
- Lawson Health Research Institute, London, Ontario, Canada.
| | - Jean-Claude Tardif
- Division of Cardiology, Montreal Heart Institute, University of Montreal, Montreal, Quebec, Canada.
| | - Rob S B Beanlands
- Molecular Function and Imaging Program and the National Cardiac PET Centre, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Department of Radiology, University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada; Division of Nuclear Medicine, Department of Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada.
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Saba L, Yuan C, Hatsukami TS, Balu N, Qiao Y, DeMarco JK, Saam T, Moody AR, Li D, Matouk CC, Johnson MH, Jäger HR, Mossa-Basha M, Kooi ME, Fan Z, Saloner D, Wintermark M, Mikulis DJ, Wasserman BA. Carotid Artery Wall Imaging: Perspective and Guidelines from the ASNR Vessel Wall Imaging Study Group and Expert Consensus Recommendations of the American Society of Neuroradiology. AJNR Am J Neuroradiol 2018; 39:E9-E31. [PMID: 29326139 DOI: 10.3174/ajnr.a5488] [Citation(s) in RCA: 183] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Identification of carotid artery atherosclerosis is conventionally based on measurements of luminal stenosis and surface irregularities using in vivo imaging techniques including sonography, CT and MR angiography, and digital subtraction angiography. However, histopathologic studies demonstrate considerable differences between plaques with identical degrees of stenosis and indicate that certain plaque features are associated with increased risk for ischemic events. The ability to look beyond the lumen using highly developed vessel wall imaging methods to identify plaque vulnerable to disruption has prompted an active debate as to whether a paradigm shift is needed to move away from relying on measurements of luminal stenosis for gauging the risk of ischemic injury. Further evaluation in randomized clinical trials will help to better define the exact role of plaque imaging in clinical decision-making. However, current carotid vessel wall imaging techniques can be informative. The goal of this article is to present the perspective of the ASNR Vessel Wall Imaging Study Group as it relates to the current status of arterial wall imaging in carotid artery disease.
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Affiliation(s)
- L Saba
- From the Department of Medical Imaging (L.S.), University of Cagliari, Cagliari, Italy
| | - C Yuan
- Departments of Radiology (C.Y., N.B., M.M.-B.)
| | - T S Hatsukami
- Surgery (T.S.H.), University of Washington, Seattle, Washington
| | - N Balu
- Departments of Radiology (C.Y., N.B., M.M.-B.)
| | - Y Qiao
- The Russell H. Morgan Department of Radiology and Radiological Sciences (Y.Q., B.A.W.), Johns Hopkins Hospital, Baltimore, Maryland
| | - J K DeMarco
- Department of Radiology (J.K.D.), Walter Reed National Military Medical Center, Bethesda, Maryland
| | - T Saam
- Department of Radiology (T.S.), Ludwig-Maximilian University Hospital, Munich, Germany
| | - A R Moody
- Department of Medical Imaging (A.R.M.), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - D Li
- Biomedical Imaging Research Institute (D.L., Z.F.), Cedars-Sinai Medical Center, Los Angeles, California
| | - C C Matouk
- Departments of Neurosurgery, Neurovascular and Stroke Programs (C.C.M., M.H.J.).,Radiology and Biomedical Imaging (C.C.M., M.H.J.)
| | - M H Johnson
- Departments of Neurosurgery, Neurovascular and Stroke Programs (C.C.M., M.H.J.).,Radiology and Biomedical Imaging (C.C.M., M.H.J.).,Surgery (M.H.J.), Yale University School of Medicine, New Haven, Connecticut
| | - H R Jäger
- Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, University College London Institute of Neurology, London, UK
| | | | - M E Kooi
- Department of Radiology (M.E.K.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Z Fan
- Biomedical Imaging Research Institute (D.L., Z.F.), Cedars-Sinai Medical Center, Los Angeles, California
| | - D Saloner
- Department of Radiology and Biomedical Imaging (D.S.), University of California, San Francisco, California
| | - M Wintermark
- Department of Radiology (M.W.), Neuroradiology Division, Stanford University, Stanford, California
| | - D J Mikulis
- Division of Neuroradiology (D.J.M.), Department of Medical Imaging, University Health Network
| | - B A Wasserman
- The Russell H. Morgan Department of Radiology and Radiological Sciences (Y.Q., B.A.W.), Johns Hopkins Hospital, Baltimore, Maryland
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Singh N, Moody AR, Zhang B, Kaminski I, Kapur K, Chiu S, Tyrrell PN. Age-Specific Sex Differences in Magnetic Resonance Imaging-Depicted Carotid Intraplaque Hemorrhage. Stroke 2017; 48:2129-2135. [PMID: 28706117 DOI: 10.1161/strokeaha.117.017877] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 05/29/2017] [Accepted: 06/12/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND PURPOSE Stroke rates are higher in men compared with women in the fourth through seventh decades of life, and higher rates may result from differences in carotid intraplaque hemorrhage (IPH), an unstable atherosclerotic plaque component. We report age-specific sex differences in the presence of magnetic resonance imaging-depicted carotid IPH. METHODS Patients (n=1115) underwent magnetic resonance imaging for carotid IPH between 2005 and 2014. Low-grade carotid stenosis patients (n=906) without prior endarterectomy were eligible for this cross-sectional study. RESULTS Of the 906 patients included (mean age±SD in years, 66.98±15.15), 63 (6.95%) had carotid IPH. In men and women, carotid IPH was present in 11.43% (48 of 420) and 3.09% (15 of 486), respectively (P<0.0001). Multivariable logistic regression analysis confirmed greater odds of carotid IPH in men for all ages: 45 to 54 (odds ratio=45.45; 95% confidence interval, 3.43-500), 55 to 64 years (odds ratio=21.74; 95% confidence interval, 3.21-142.86), 65 to 74 years (odds ratio=10.42; 95% confidence interval, 2.91-37.04), and ≥75 years (odds ratio=5.00; 95% confidence interval, 2.31-10.75). Male sex modified the effect of age on the presence of carotid IPH (β=0.074; SE=0.036; P=0.0411). CONCLUSIONS Men have greater age-specific odds of magnetic resonance imaging-depicted carotid IPH compared with women. With increasing age post-menopause, the odds of carotid IPH in women becomes closer to that of men. Delayed onset of carotid IPH in women, an unstable plaque component, may partly explain differential stroke rates between sexes, and further studies are warranted.
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Affiliation(s)
- Navneet Singh
- From the Department of Medical Imaging, Faculty of Medicine (N.S., A.R.M., B.Z., I.K., S.C., P.N.T.) and Department of Statistical Sciences (P.N.T.), University of Toronto, Ontario, Canada; and Department of Neurology, Boston Children's Hospital, Harvard Medical School, MA (K.K.)
| | - Alan R Moody
- From the Department of Medical Imaging, Faculty of Medicine (N.S., A.R.M., B.Z., I.K., S.C., P.N.T.) and Department of Statistical Sciences (P.N.T.), University of Toronto, Ontario, Canada; and Department of Neurology, Boston Children's Hospital, Harvard Medical School, MA (K.K.).
| | - Bowen Zhang
- From the Department of Medical Imaging, Faculty of Medicine (N.S., A.R.M., B.Z., I.K., S.C., P.N.T.) and Department of Statistical Sciences (P.N.T.), University of Toronto, Ontario, Canada; and Department of Neurology, Boston Children's Hospital, Harvard Medical School, MA (K.K.)
| | - Isabella Kaminski
- From the Department of Medical Imaging, Faculty of Medicine (N.S., A.R.M., B.Z., I.K., S.C., P.N.T.) and Department of Statistical Sciences (P.N.T.), University of Toronto, Ontario, Canada; and Department of Neurology, Boston Children's Hospital, Harvard Medical School, MA (K.K.)
| | - Kush Kapur
- From the Department of Medical Imaging, Faculty of Medicine (N.S., A.R.M., B.Z., I.K., S.C., P.N.T.) and Department of Statistical Sciences (P.N.T.), University of Toronto, Ontario, Canada; and Department of Neurology, Boston Children's Hospital, Harvard Medical School, MA (K.K.)
| | - Stephanie Chiu
- From the Department of Medical Imaging, Faculty of Medicine (N.S., A.R.M., B.Z., I.K., S.C., P.N.T.) and Department of Statistical Sciences (P.N.T.), University of Toronto, Ontario, Canada; and Department of Neurology, Boston Children's Hospital, Harvard Medical School, MA (K.K.)
| | - Pascal N Tyrrell
- From the Department of Medical Imaging, Faculty of Medicine (N.S., A.R.M., B.Z., I.K., S.C., P.N.T.) and Department of Statistical Sciences (P.N.T.), University of Toronto, Ontario, Canada; and Department of Neurology, Boston Children's Hospital, Harvard Medical School, MA (K.K.)
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13
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Chiavaroli L, Mirrahimi A, Ireland C, Mitchell S, Sahye-Pudaruth S, Coveney J, Olowoyeye O, Maraj T, Patel D, de Souza RJ, Augustin LSA, Bashyam B, Blanco Mejia S, Nishi SK, Leiter LA, Josse RG, McKeown-Eyssen G, Moody AR, Berger AR, Kendall CWC, Sievenpiper JL, Jenkins DJA. Low-glycaemic index diet to improve glycaemic control and cardiovascular disease in type 2 diabetes: design and methods for a randomised, controlled, clinical trial. BMJ Open 2016; 6:e012220. [PMID: 27388364 PMCID: PMC4947767 DOI: 10.1136/bmjopen-2016-012220] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 05/31/2016] [Accepted: 06/03/2016] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Type 2 diabetes (T2DM) produces macrovascular and microvascular damage, significantly increasing the risk of cardiovascular disease (CVD), renal failure and blindness. As rates of T2DM rise, the need for effective dietary and other lifestyle changes to improve diabetes management become more urgent. Low-glycaemic index (GI) diets may improve glycaemic control in diabetes in the short term; however, there is a lack of evidence on the long-term adherence to low-GI diets, as well as on the association with surrogate markers of CVD beyond traditional risk factors. Recently, advances have been made in measures of subclinical arterial disease through the use of MRI, which, along with standard measures from carotid ultrasound (CUS) scanning, have been associated with CVD events. We therefore designed a randomised, controlled, clinical trial to assess whether low-GI dietary advice can significantly improve surrogate markers of CVD and long-term glycaemic control in T2DM. METHODS AND ANALYSIS 169 otherwise healthy individuals with T2DM were recruited to receive intensive counselling on a low-GI or high-cereal fibre diet for 3 years. To assess macrovascular disease, MRI and CUS are used, and to assess microvascular disease, retinal photography and 24-hour urinary collections are taken at baseline and years 1 and 3. Risk factors for CVD are assessed every 3 months. ETHICS AND DISSEMINATION The study protocol and consent form have been approved by the research ethics board of St. Michael's Hospital. If the study shows a benefit, these data will support the use of low-GI and/or high-fibre foods in the management of T2DM and its complications. TRIAL REGISTRATION NUMBER NCT01063374; Pre-results.
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Affiliation(s)
- Laura Chiavaroli
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Arash Mirrahimi
- Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada Faculty of Health Sciences, School of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Christopher Ireland
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Sandra Mitchell
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Sandhya Sahye-Pudaruth
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Judy Coveney
- Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Omodele Olowoyeye
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Tishan Maraj
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Darshna Patel
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Russell J de Souza
- Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada Department of Clinical Epidemiology and Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Livia S A Augustin
- Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada National Cancer Institute "Fondazione G. Pascale", Naples, Italy
| | - Balachandran Bashyam
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Sonia Blanco Mejia
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Stephanie K Nishi
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Lawrence A Leiter
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Robert G Josse
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Gail McKeown-Eyssen
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Alan R Moody
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Alan R Berger
- Department of Ophthalmology, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Cyril W C Kendall
- Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - John L Sievenpiper
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada
| | - David J A Jenkins
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada
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14
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Ramirez J, McNeely AA, Scott CJ, Masellis M, Black SE. White matter hyperintensity burden in elderly cohort studies: The Sunnybrook Dementia Study, Alzheimer's Disease Neuroimaging Initiative, and Three‐City Study. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.06.1886] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Joel Ramirez
- LC Campbell Cognitive Neurology Research Unit, Brain Sciences Research Program Sunnybrook Research Institute Toronto Canada
- Heart & Stroke Foundation Canadian Partnership for Stroke Recovery Sunnybrook Health Sciences Centre (SHSC) Toronto Canada
| | - Alicia A. McNeely
- LC Campbell Cognitive Neurology Research Unit, Brain Sciences Research Program Sunnybrook Research Institute Toronto Canada
- Heart & Stroke Foundation Canadian Partnership for Stroke Recovery Sunnybrook Health Sciences Centre (SHSC) Toronto Canada
| | - Christopher J.M. Scott
- LC Campbell Cognitive Neurology Research Unit, Brain Sciences Research Program Sunnybrook Research Institute Toronto Canada
- Heart & Stroke Foundation Canadian Partnership for Stroke Recovery Sunnybrook Health Sciences Centre (SHSC) Toronto Canada
| | - Mario Masellis
- LC Campbell Cognitive Neurology Research Unit, Brain Sciences Research Program Sunnybrook Research Institute Toronto Canada
- Heart & Stroke Foundation Canadian Partnership for Stroke Recovery Sunnybrook Health Sciences Centre (SHSC) Toronto Canada
- Institute of Medical Science University of Toronto (UT) Toronto Canada
- Neurogenetics Section Centre for Addiction and Mental Health Toronto Canada
- Department of Medicine Neurology, SHSC and UT Toronto Canada
| | - Sandra E. Black
- LC Campbell Cognitive Neurology Research Unit, Brain Sciences Research Program Sunnybrook Research Institute Toronto Canada
- Heart & Stroke Foundation Canadian Partnership for Stroke Recovery Sunnybrook Health Sciences Centre (SHSC) Toronto Canada
- Institute of Medical Science University of Toronto (UT) Toronto Canada
- Department of Medicine Neurology, SHSC and UT Toronto Canada
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15
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Abstract
General thinking has previously centered on managing carotid artery stenosis (CAS) by carotid endarterectomy and subsequently, stenting for higher risk patients. However for CAS and other forms of vascular disease, especially when asymptomatic, there is new emphasis on defining underlying mechanisms. Knowledge of these mechanisms can lead to medical treatments that result in possible atherosclerotic plaque stabilization, and even plaque regression, including in the patient with CAS. For now, the key medication class for a medical approach are the statins. Their use is supported by good cardiovascular clinical trial evidence including some directed carotid artery studies, especially with a demonstrated decrease in carotid intima-media thickness. Procedural controversy still exists but the current era in medicine offers significant support for medical management of asymptomatic CAS while techniques to recognize the vulnerable plaque evolve. If CAS converts to a symptomatic status, early referral for endarterectomy or stenting is indicated.
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Affiliation(s)
- Thomas F Whayne
- Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky, Lexington, Kentucky
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16
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McArdle B, Dowsley TF, Cocker MS, Ohira H, deKemp RA, DaSilva J, Ruddy TD, Chow BJ, Beanlands RS. Cardiac PET: metabolic and functional imaging of the myocardium. Semin Nucl Med 2014; 43:434-48. [PMID: 24094711 DOI: 10.1053/j.semnuclmed.2013.06.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Cardiac PET has evolved over the past 30 years to gain wider acceptance as a valuable modality for a variety of cardiac conditions. Wider availability of scanners as well as changes in reimbursement policies in more recent years has further increased its use. Moreover, with the emergence of novel radionuclides as well as further advances in scanner technology, the use of cardiac PET can be expected to increase further in both clinical practice and the research arena. PET has demonstrated superior diagnostic accuracy for the diagnosis of coronary artery disease in comparison with single-photon emission tomography while it provides robust prognostic value. The addition of absolute flow quantification increases sensitivity for 3-vessel disease as well as providing incremental functional and prognostic information. Metabolic imaging using (18)F-fluorodeoxyglucose can be used to guide revascularization in the setting of heart failure and also to detect active inflammation in conditions such as cardiac sarcoidosis and within atherosclerotic plaque, improving our understanding of the processes that underlie these conditions. However, although the pace of new developments is rapid, there remains a gap in evidence for many of these advances and further studies are required.
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Affiliation(s)
- Brian McArdle
- National Cardiac PET Centre, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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17
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van Engelen A, Niessen WJ, Klein S, Groen HC, Verhagen HJM, Wentzel JJ, van der Lugt A, de Bruijne M. Atherosclerotic plaque component segmentation in combined carotid MRI and CTA data incorporating class label uncertainty. PLoS One 2014; 9:e94840. [PMID: 24762678 PMCID: PMC3999092 DOI: 10.1371/journal.pone.0094840] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Accepted: 03/19/2014] [Indexed: 11/22/2022] Open
Abstract
Atherosclerotic plaque composition can indicate plaque vulnerability. We segment atherosclerotic plaque components from the carotid artery on a combination of in vivo MRI and CT-angiography (CTA) data using supervised voxelwise classification. In contrast to previous studies the ground truth for training is directly obtained from 3D registration with histology for fibrous and lipid-rich necrotic tissue, and with μCT for calcification. This registration does, however, not provide accurate voxelwise correspondence. We therefore evaluate three approaches that incorporate uncertainty in the ground truth used for training: I) soft labels are created by Gaussian blurring of the original binary histology segmentations to reduce weights at the boundaries between components, and are weighted by the estimated registration accuracy of the histology and in vivo imaging data (measured by overlap), II) samples are weighted by the local contour distance of the lumen and outer wall between histology and in vivo data, and III) 10% of each class is rejected by Gaussian outlier rejection. Classification was evaluated on the relative volumes (% of tissue type in the vessel wall) for calcified, fibrous and lipid-rich necrotic tissue, using linear discriminant (LDC) and support vector machine (SVM) classification. In addition, the combination of MRI and CTA data was compared to using only one imaging modality. Best results were obtained by LDC and outlier rejection: the volume error per vessel was 0.9±1.0% for calcification, 12.7±7.6% for fibrous and 12.1±8.1% for necrotic tissue, with Spearman rank correlation coefficients of 0.91 (calcification), 0.80 (fibrous) and 0.81 (necrotic). While segmentation using only MRI features yielded low accuracy for calcification, and segmentation using only CTA features yielded low accuracy for necrotic tissue, the combination of features from MRI and CTA gave good results for all studied components.
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Affiliation(s)
- Arna van Engelen
- Biomedical Imaging Group Rotterdam, Departments of Medical Informatics & Radiology, Erasmus MC, Rotterdam, the Netherlands
| | - Wiro J. Niessen
- Biomedical Imaging Group Rotterdam, Departments of Medical Informatics & Radiology, Erasmus MC, Rotterdam, the Netherlands
- Department of Imaging Science and Technology, Faculty of Applied Sciences, Delft University of Technology, Delft, the Netherlands
| | - Stefan Klein
- Biomedical Imaging Group Rotterdam, Departments of Medical Informatics & Radiology, Erasmus MC, Rotterdam, the Netherlands
| | - Harald C. Groen
- Department of Biomedical Engineering, Erasmus MC, Rotterdam, the Netherlands
- Department of Radiology, Erasmus MC, Rotterdam, the Netherlands
- Department of Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands
| | | | - Jolanda J. Wentzel
- Department of Biomedical Engineering, Erasmus MC, Rotterdam, the Netherlands
| | | | - Marleen de Bruijne
- Biomedical Imaging Group Rotterdam, Departments of Medical Informatics & Radiology, Erasmus MC, Rotterdam, the Netherlands
- Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
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18
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Cardiovascular imaging: new directions in an evolving landscape. Can J Cardiol 2013; 29:257-9. [PMID: 23439017 DOI: 10.1016/j.cjca.2013.01.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 01/22/2013] [Indexed: 11/20/2022] Open
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19
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Cocker MS, Mc Ardle B, Spence JD, Lum C, Hammond RR, Ongaro DC, McDonald MA, deKemp RA, Tardif JC, Beanlands RSB. Imaging atherosclerosis with hybrid [18F]fluorodeoxyglucose positron emission tomography/computed tomography imaging: what Leonardo da Vinci could not see. J Nucl Cardiol 2012; 19:1211-25. [PMID: 23073913 PMCID: PMC3510422 DOI: 10.1007/s12350-012-9631-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Prodigious efforts and landmark discoveries have led toward significant advances in our understanding of atherosclerosis. Despite significant efforts, atherosclerosis continues globally to be a leading cause of mortality and reduced quality of life. With surges in the prevalence of obesity and diabetes, atherosclerosis is expected to have an even more pronounced impact upon the global burden of disease. It is imperative to develop strategies for the early detection of disease. Positron emission tomography (PET) imaging utilizing [(18)F]fluorodeoxyglucose (FDG) may provide a non-invasive means of characterizing inflammatory activity within atherosclerotic plaque, thus serving as a surrogate biomarker for detecting vulnerable plaque. The aim of this review is to explore the rationale for performing FDG imaging, provide an overview into the mechanism of action, and summarize findings from the early application of FDG PET imaging in the clinical setting to evaluate vascular disease. Alternative imaging biomarkers and approaches are briefly discussed.
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Affiliation(s)
- Myra S. Cocker
- Molecular Function and Imaging Program, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7 Canada
| | - Brian Mc Ardle
- Molecular Function and Imaging Program, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7 Canada
| | - J. David Spence
- Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute, University of Western Ontario, 1400 Western Road, London, ON Canada
| | - Cheemun Lum
- Interventional & Diagnostic Neuroradiology, Department of Radiology, The Ottawa
Hospital, University of Ottawa, Civic Campus, Diagnostic Imaging, K1Y 4E9 Ottawa, ON Canada
| | - Robert R. Hammond
- Departments of Pathology and Clinical Neurological Sciences, London Health Sciences Centre and University of Western Ontario, 339 Windermere Road, N6A 5A5 London, ON Canada
| | - Deidre C. Ongaro
- Molecular Function and Imaging Program, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7 Canada
| | - Matthew A. McDonald
- Molecular Function and Imaging Program, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7 Canada
| | - Robert A. deKemp
- Molecular Function and Imaging Program, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7 Canada
| | | | - Rob S. B. Beanlands
- Molecular Function and Imaging Program, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7 Canada
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