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Dumitriu LaGrange D, Xin L, Lazeyras F, Doyle KM, Wanke I, Lövblad KO. MRI characterization of in vitro clots at 3T and 7T: A technical note. J Neuroradiol 2024; 51:38-42. [PMID: 37364745 DOI: 10.1016/j.neurad.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 06/22/2023] [Accepted: 06/23/2023] [Indexed: 06/28/2023]
Abstract
In acute ischemic stroke, the composition of the occlusive clot can be associated with the underlying pathophysiology and the response to treatment. For these reasons, it is important to characterize the clot composition from clinical scans. We examine the ability of 3T and 7T MRI to distinguish the composition of in vitro clots, using quantitative T1 and T2*, alternatively R2*, mapping. When comparing the two field strengths, we found a tradeoff between sensitivity for clot composition and confidence in the clot depiction associated with spatial resolution. The loss of sensitivity at 7T can be mitigated by combining the T1 and T2* signals.
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Affiliation(s)
- Daniela Dumitriu LaGrange
- Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
| | - Lijing Xin
- CIBM Center for Biomedical Imaging, Switzerland; Ecole Polytechnique Fédérale de Lausanne (EPFL), Animal Imaging and Technology, Lausanne, Switzerland
| | - François Lazeyras
- Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland; CIBM Center for Biomedical Imaging, Switzerland
| | - Karen M Doyle
- Department of Physiology, University of Galway, Ireland; CURAM, Science Foundation Ireland (SFI) Centre for Research in Medical Devices, University of Galway, Ireland
| | - Isabel Wanke
- Division of Neuroradiology, Klinik Hirslanden, Zurich, Switzerland; Swiss Neuroradiology Institute, Zurich, Switzerland; Division of Neuroradiology, University of Essen, Essen, Germany
| | - Karl-Olof Lövblad
- Division of Diagnostic and Interventional Neuroradiology, HUG Geneva University Hospitals, Geneva, Switzerland; Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Dumitriu LaGrange D, Braunersreuther V, Wanke I, Berberat J, Luthman S, Fitzgerald S, Doyle KM, Brina O, Reymond P, Platon A, Muster M, Machi P, Poletti PA, Vargas MI, Lövblad KO. MicroCT Can Characterize Clots Retrieved With Mechanical Thrombectomy From Acute Ischemic Stroke Patients–A Preliminary Report. Front Neurol 2022; 13:824091. [PMID: 35321513 PMCID: PMC8934771 DOI: 10.3389/fneur.2022.824091] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 01/31/2022] [Indexed: 11/18/2022] Open
Abstract
Background Characterization of the clot occluding the arteries in acute ischemic stroke received ample attention, in terms of elucidating the relationship between the clot composition, its etiology and its amenability for pharmacological treatment and mechanical thrombectomy approaches. Traditional analytical techniques such as conventional 2D histopathology or electron microscopy sample only small parts of the clot. Visualization and analysis in 3D are necessary to depict and comprehend the overall organization of the clot. The aim of this study is to investigate the potential of microCT for characterizing the clot composition, structure, and organization. Methods In a pilot study, we analyzed with microCT clots retrieved from 14 patients with acute ischemic stroke. The following parameters were analyzed: overall clot density, clot segmentation with various density thresholds, clot volume. Results Our findings show that human clots are heterogeneous in terms of CT intra-clot density distribution. After fixation in formalin, the clots display a shift toward negative values. On average, we found the mean HU values of red clots retrieved from patients to be −153 HU, with SD = 23.8 HU, for the intermediate clots retrieved from patients −193 HU, SD = 23.7 HU, and for the white clots retrieved from patients −229 HU, SD = 64.8 HU. Conclusion Our study shows that volumetric and density analysis of the clot opens new perspectives for clot characterization and for a better understanding of thrombus structure and composition.
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Affiliation(s)
- Daniela Dumitriu LaGrange
- Division of Diagnostic and Interventional Neuroradiology, HUG Geneva University Hospitals, Geneva, Switzerland
- *Correspondence: Daniela Dumitriu LaGrange
| | - Vincent Braunersreuther
- Division of Clinical Pathology, Diagnostic Department, HUG Geneva University Hospitals, Geneva, Switzerland
| | - Isabel Wanke
- Division of Neuroradiology, Klinik Hirslanden, Zurich, Switzerland
- Swiss Neuroradiology Institute, Zurich, Switzerland
- Division of Neuroradiology, University of Essen, Essen, Germany
| | - Jatta Berberat
- Department of Psychiatry, University of Geneva, Geneva, Switzerland
- Division of Neuroradiology, Kantonsspital Aarau, Aarau, Switzerland
| | - Siri Luthman
- Division of Diagnostic and Interventional Neuroradiology, HUG Geneva University Hospitals, Geneva, Switzerland
| | - Seán Fitzgerald
- Department of Physiology, National University of Ireland, Galway, Ireland
- CÚRAM, Science Foundation Ireland (SFI), Centre for Research in Medical Devices, National University of Ireland Galway, Galway, Ireland
| | - Karen M. Doyle
- Department of Physiology, National University of Ireland, Galway, Ireland
- CÚRAM, Science Foundation Ireland (SFI), Centre for Research in Medical Devices, National University of Ireland Galway, Galway, Ireland
| | - Olivier Brina
- Division of Diagnostic and Interventional Neuroradiology, HUG Geneva University Hospitals, Geneva, Switzerland
| | - Philippe Reymond
- Division of Diagnostic and Interventional Neuroradiology, HUG Geneva University Hospitals, Geneva, Switzerland
| | - Alexandra Platon
- Division of Radiology, HUG Geneva University Hospitals, Geneva, Switzerland
| | - Michel Muster
- Division of Diagnostic and Interventional Neuroradiology, HUG Geneva University Hospitals, Geneva, Switzerland
| | - Paolo Machi
- Division of Diagnostic and Interventional Neuroradiology, HUG Geneva University Hospitals, Geneva, Switzerland
| | | | - Maria Isabel Vargas
- Division of Diagnostic and Interventional Neuroradiology, HUG Geneva University Hospitals, Geneva, Switzerland
| | - Karl-Olof Lövblad
- Division of Diagnostic and Interventional Neuroradiology, HUG Geneva University Hospitals, Geneva, Switzerland
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LaGrange DD, Wanke I, Machi P, Bernava G, Vargas M, Botta D, Berberat J, Muster M, Platon A, Poletti PA, Lövblad KO. Multimodality Characterization of the Clot in Acute Stroke. Front Neurol 2022; 12:760148. [PMID: 34970209 PMCID: PMC8712945 DOI: 10.3389/fneur.2021.760148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 11/17/2021] [Indexed: 11/26/2022] Open
Abstract
Aim: Current treatment of occluded cerebral vessels can be done by a variety of endovascular techniques. Sometimes, the clot responds in varying degrees to the treatment chosen. The Ex vivo characterization of the clot occluding the arteries in acute ischemic stroke can help in understanding the underlying imaging features obtained from pre-treatment brain scans. For this reason, we explored the potential of microCT when combined with electron microscopy for clot characterization. Results were compared to the clinical CT findings. Methods: 16 patients (9 males, 8 females, age range 54–93 years) who were referred to our institution for acute stroke underwent dual-source CT. Results: Clinical CT clots were seen as either iso or hyperdense. This was corroborated with micro-CT, and electron microscopy can show the detailed composition. Conclusion: MicroCT values can be used as an indicator for red blood cells-rich composition of clots. Meaningful information regarding the clot composition and modalities of embedding along the stent retrievers can be obtained through a combination of microCT and electron microscopy.
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Affiliation(s)
- Daniela Dumitriu LaGrange
- Division of Diagnostic and Interventional Neuroradiology, Diagnostic Department, HUG Geneva University Hospitals, Genève, Switzerland
| | - Isabel Wanke
- Division of Neuroradiology, Zentrum für Neuroradiologie, Klinik Hirslanden, Zurich, Switzerland.,Swiss Neuroradiology Institute, Zurich, Switzerland.,Division of Neuroradiology, Institute of Diagnostic and Interventional Radiology and Neuroradiology, University of Essen, Essen, Germany
| | - Paolo Machi
- Division of Diagnostic and Interventional Neuroradiology, Diagnostic Department, HUG Geneva University Hospitals, Genève, Switzerland
| | - Gianmarco Bernava
- Division of Diagnostic and Interventional Neuroradiology, Diagnostic Department, HUG Geneva University Hospitals, Genève, Switzerland
| | - Maria Vargas
- Division of Diagnostic and Interventional Neuroradiology, Diagnostic Department, HUG Geneva University Hospitals, Genève, Switzerland
| | - Daniele Botta
- Division of Radiology, Diagnostic Department, Geneva University Hospitals, Genève, Switzerland
| | - Jatta Berberat
- Division of Neuroradiology, Zentrale Medizinische Dienste, Kantonsspital Aarau, Aarau, Switzerland
| | - Michel Muster
- Division of Diagnostic and Interventional Neuroradiology, Diagnostic Department, HUG Geneva University Hospitals, Genève, Switzerland
| | - Alexandra Platon
- Division of Radiology, Diagnostic Department, Geneva University Hospitals, Genève, Switzerland
| | | | - Karl-Olof Lövblad
- Division of Diagnostic and Interventional Neuroradiology, Diagnostic Department, HUG Geneva University Hospitals, Genève, Switzerland
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