Numerical simulations of carotid MRI quantify the accuracy in measuring atherosclerotic plaque components in vivo
Corresponding Author
Harm A. Nieuwstadt
Department of Biomedical Engineering, Erasmus Medical Center, Rotterdam, the Netherlands
Correspondence to: Harm A. Nieuwstadt, Erasmus Medical Center, Department of Biomedical Engineering, Biomechanics Laboratory Ee2322, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands. E-mail: [email protected]Search for more papers by this authorMartine T. B. Truijman
Department of Radiology, Maastricht University Medical Center, Maastricht, the Netherlands
Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
Search for more papers by this authorM. Eline Kooi
Department of Radiology, Maastricht University Medical Center, Maastricht, the Netherlands
Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
Search for more papers by this authorAad van der Lugt
Department of Radiology, Erasmus Medical Center, Rotterdam, the Netherlands
Search for more papers by this authorAnton F. W. van der Steen
Department of Biomedical Engineering, Erasmus Medical Center, Rotterdam, the Netherlands
Search for more papers by this authorJolanda J. Wentzel
Department of Biomedical Engineering, Erasmus Medical Center, Rotterdam, the Netherlands
Search for more papers by this authorMarcel Breeuwer
Philips Healthcare, Best, the Netherlands
Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
Search for more papers by this authorFrank J. H. Gijsen
Department of Biomedical Engineering, Erasmus Medical Center, Rotterdam, the Netherlands
Search for more papers by this authorCorresponding Author
Harm A. Nieuwstadt
Department of Biomedical Engineering, Erasmus Medical Center, Rotterdam, the Netherlands
Correspondence to: Harm A. Nieuwstadt, Erasmus Medical Center, Department of Biomedical Engineering, Biomechanics Laboratory Ee2322, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands. E-mail: [email protected]Search for more papers by this authorMartine T. B. Truijman
Department of Radiology, Maastricht University Medical Center, Maastricht, the Netherlands
Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
Search for more papers by this authorM. Eline Kooi
Department of Radiology, Maastricht University Medical Center, Maastricht, the Netherlands
Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
Search for more papers by this authorAad van der Lugt
Department of Radiology, Erasmus Medical Center, Rotterdam, the Netherlands
Search for more papers by this authorAnton F. W. van der Steen
Department of Biomedical Engineering, Erasmus Medical Center, Rotterdam, the Netherlands
Search for more papers by this authorJolanda J. Wentzel
Department of Biomedical Engineering, Erasmus Medical Center, Rotterdam, the Netherlands
Search for more papers by this authorMarcel Breeuwer
Philips Healthcare, Best, the Netherlands
Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
Search for more papers by this authorFrank J. H. Gijsen
Department of Biomedical Engineering, Erasmus Medical Center, Rotterdam, the Netherlands
Search for more papers by this authorAbstract
Purpose
Atherosclerotic carotid plaques can be quantified in vivo by MRI. However, the accuracy in segmentation and quantification of components such as the thin fibrous cap (FC) and lipid-rich necrotic core (LRNC) remains unknown due to the lack of a submillimeter scale ground truth.
Methods
A novel approach was taken by numerically simulating in vivo carotid MRI providing a ground truth comparison. Upon evaluation of a simulated clinical protocol, MR readers segmented simulated images of cross-sectional plaque geometries derived from histological data of 12 patients.
Results
MR readers showed high correlation (R) and intraclass correlation (ICC) in measuring the luminal area (R = 0.996, ICC = 0.99), vessel wall area (R = 0.96, ICC = 0.94) and LRNC area (R = 0.95, ICC = 0.94). LRNC area was underestimated (mean error, −24%). Minimum FC thickness showed a mediocre correlation and intraclass correlation (R = 0.71, ICC = 0.69).
Conclusion
Current clinical MRI can quantify carotid plaques but shows limitations for thin FC thickness quantification. These limitations could influence the reliability of carotid MRI for assessing plaque rupture risk associated with FC thickness. Overall, MRI simulations provide a feasible methodology for assessing segmentation and quantification accuracy, as well as for improving scan protocol design. Magn Reson Med 72:188–201, 2014. © 2013 Wiley Periodicals, Inc.
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