title: Scan-rescan reproducibility of quantitative assessment of inflammatory carotid atherosclerotic plaque using dynamic contrast-enhanced 3T CMR in a multi-center study.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.forename: Huijun
authors.initials: H
authors.lastname: Chen
authors.forename: Jie
authors.initials: J
authors.lastname: Sun
authors.forename: William S
authors.initials: WS
authors.lastname: Kerwin
authors.forename: Niranjan
authors.initials: N
authors.lastname: Balu
authors.forename: Moni B
authors.initials: MB
authors.lastname: Neradilek
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Hippe
authors.forename: Daniel
authors.initials: D
authors.lastname: Isquith
authors.forename: Yunjing
authors.initials: Y
authors.lastname: Xue
authors.forename: Kiyofumi
authors.initials: K
authors.lastname: Yamada
authors.forename: Suzanne
authors.initials: S
authors.lastname: Peck
authors.forename: Chun
authors.initials: C
authors.lastname: Yuan
authors.forename: Kevin D
authors.initials: KD
authors.lastname: O'Brien
authors.forename: Xue-Qiao
authors.initials: XQ
authors.lastname: Zhao
mesh_terms: D000368:Aged; D002339:Carotid Arteries / Q000473:pathology*; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000473:pathology; D002681:China; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007249:Inflammation / Q000175:diagnosis* / Q000473:pathology; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009656:North America; D010352:Patient Dropouts; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D013997:Time Factors
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA
references.citation: J Cardiovasc Magn Reson. 2005;7(5):799-808
references.pmid: 16353440
references.citation: J Vasc Surg. 1999 Aug;30(2):261-8
references.pmid: 10436445
references.citation: Magn Reson Med. 2011 Sep;66(3):868-78
references.pmid: 21394770
references.citation: Nat Rev Drug Discov. 2011 May;10(5):365-76
references.pmid: 21532566
references.citation: J Vasc Surg. 2007 Jan;45(1):155-9
references.pmid: 17210401
references.citation: N Engl J Med. 2011 Dec 15;365(24):2255-67
references.pmid: 22085343
references.citation: Stroke. 2014 Jun;45(6):1842-5
references.pmid: 24788973
references.citation: Stroke. 2013 Apr;44(4):1031-6
references.pmid: 23471271
references.citation: Arterioscler Thromb Vasc Biol. 2008 Jul;28(7):1311-7
references.pmid: 18467641
references.citation: Radiology. 2011 Jul;260(1):224-31
references.pmid: 21493792
references.citation: J Cardiovasc Magn Reson. 2012 Jun 21;14:43
references.pmid: 22721175
references.citation: Magn Reson Med. 2008 Mar;59(3):507-14
references.pmid: 18306402
references.citation: Radiology. 2013 Jan;266(1):271-9
references.pmid: 23151823
references.citation: Top Magn Reson Imaging. 2007 Oct;18(5):371-8
references.pmid: 18025991
references.citation: Nat Med. 2011 Nov 07;17(11):1410-22
references.pmid: 22064431
references.citation: Br J Surg. 2001 Jul;88(7):945-50
references.pmid: 11442525
references.citation: Magn Reson Med. 2013 Jun;69(6):1712-20
references.pmid: 22829477
references.citation: Radiology. 2009 Sep;252(3):789-96
references.pmid: 19508991
references.citation: Radiology. 2006 Nov;241(2):459-68
references.pmid: 16966482
references.citation: Nature. 2002 Dec 19-26;420(6917):868-74
references.pmid: 12490960
references.citation: JACC Cardiovasc Imaging. 2011 Oct;4(10):1100-9
references.pmid: 21999870
references.citation: Circulation. 2003 Feb 18;107(6):851-6
references.pmid: 12591755
references.citation: J Cereb Blood Flow Metab. 1983 Mar;3(1):1-7
references.pmid: 6822610
references.citation: Am J Cardiol. 2002 Jul 1;90(1):29-34
references.pmid: 12088775