title: Multi-contrast atherosclerosis characterization (MATCH) of carotid plaque with a single 5-min scan: technical development and clinical feasibility.
abstract: BACKGROUND
  Multi-contrast weighted imaging is a commonly used cardiovascular magnetic resonance (CMR) protocol for characterization of carotid plaque composition. However, this approach is limited in several aspects including low slice resolution, long scan time, image mis-registration, and complex image interpretation. In this work, a 3D CMR technique, named Multi-contrast Atherosclerosis Characterization (MATCH), was developed to mitigate the above limitations.
  
  
  METHODS
  MATCH employs a 3D spoiled segmented fast low angle shot readout to acquire data with three different contrast weightings in an interleaved fashion. The inherently co-registered image sets, hyper T1-weighting, gray blood, and T2-weighting, are used to detect intra-plaque hemorrhage (IPH), calcification (CA), lipid-rich necrotic core (LRNC), and loose-matrix (LM). The MATCH sequence was optimized by computer simulations and testing on four healthy volunteers and then evaluated in a pilot study of six patients with carotid plaque, using the conventional multi-contrast protocol as a reference.
  
  
  RESULTS
  On MATCH images, the major plaque components were easy to identify. Spatial co-registration between the three image sets with MATCH was particularly helpful for the reviewer to discern co-existent components in an image and appreciate their spatial relation. Based on Cohen's kappa tests, moderate to excellent agreement in the image-based or artery-based component detection between the two protocols was obtained for LRNC, IPH, CA, and LM, respectively. Compared with the conventional multi-contrast protocol, the MATCH protocol yield significantly higher signal contrast ratio for IPH (3.1±1.3 vs. 0.4±0.3, p<0.001) and CA (1.6±1.5 vs. 0.7±0.6, p=0.012) with respect to the vessel wall.
  
  
  CONCLUSIONS
  To the best of our knowledge, the proposed MATCH sequence is the first 3D CMR technique that acquires spatially co-registered multi-contrast image sets in a single scan for characterization of carotid plaque composition. Our pilot clinical study suggests that the MATCH-based protocol may outperform the conventional multi-contrast protocol in several respects. With further technical improvements and large-scale clinical validation, MATCH has the potential to become a CMR method for assessing the risk of plaque disruption in a clinical workup.
authors.forename: Zhaoyang
authors.initials: Z
authors.lastname: Fan
authors.forename: Wei
authors.initials: W
authors.lastname: Yu
authors.forename: Yibin
authors.initials: Y
authors.lastname: Xie
authors.forename: Li
authors.initials: L
authors.lastname: Dong
authors.forename: Lixin
authors.initials: L
authors.lastname: Yang
authors.forename: Zhanhong
authors.initials: Z
authors.lastname: Wang
authors.forename: Antonio Hernandez
authors.initials: AH
authors.lastname: Conte
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Bi
authors.forename: Jing
authors.initials: J
authors.lastname: An
authors.forename: Tianjing
authors.initials: T
authors.lastname: Zhang
authors.forename: Gerhard
authors.initials: G
authors.lastname: Laub
authors.forename: Prediman Krishan
authors.initials: PK
authors.lastname: Shah
authors.forename: Zhaoqi
authors.initials: Z
authors.lastname: Zhang
authors.forename: Debiao
authors.initials: D
authors.lastname: Li
mesh_terms: D000368:Aged; D000465:Algorithms; D002339:Carotid Arteries / Q000473:pathology*; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000473:pathology; D003198:Computer Simulation; D003287:Contrast Media; D005240:Feasibility Studies; D005355:Fibrosis; D006470:Hemorrhage / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D009336:Necrosis; D010865:Pilot Projects; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D059629:Signal-To-Noise Ratio; D061205:Vascular Calcification / Q000175:diagnosis / Q000473:pathology
chemical_list: D003287:Contrast Media