title: Ex vivo differential phase contrast and magnetic resonance imaging for characterization of human carotid atherosclerotic plaques.
abstract: Non-invasive detection of specific atherosclerotic plaque components related to vulnerability is of high clinical relevance to prevent cerebrovascular events. The feasibility of magnetic resonance imaging (MRI) for characterization of plaque components was already demonstrated. We aimed to evaluate the potential of ex vivo differential phase contrast X-ray tomography (DPC) to accurately characterize human carotid plaque components in comparison to high field multicontrast MRI and histopathology. Two human plaque segments, obtained from carotid endarterectomy, classified according to criteria of the American Heart Association as stable and unstable plaque, were examined by ex vivo DPC tomography and multicontrast MRI (T1-, T2-, and proton density-weighted imaging, magnetization transfer contrast, diffusion-weighted imaging). To identify specific plaque components, the plaques were subsequently sectioned and stained for fibrous and cellular components, smooth muscle cells, hemosiderin, and fibrin. Histological data were then matched with DPC and MR images to define signal criteria for atherosclerotic plaque components. Characteristic structures, such as the lipid and necrotic core covered by a fibrous cap, calcification and hemosiderin deposits were delineated by histology and found with excellent sensitivity, resolution and accuracy in both imaging modalities. DPC tomography was superior to MRI regarding resolution and soft tissue contrast. Ex vivo DPC tomography allowed accurate identification of structures and components of atherosclerotic plaques at different lesion stages, in good correlation with histopathological findings.
authors.affiliation: Department of Chemistry and Applied Biosciences of ETH Zurich, Center for Radiopharmaceutical Sciences ETH-PSI-USZ, Vladimir-Prelog-Weg 1-5/10, 8093, Zurich, Switzerland.
authors.forename: Romana
authors.initials: R
authors.lastname: Meletta
authors.affiliation: Institute of Veterinary Pathology, University of Zurich, Winterthurerstrasse 268, 8057, Zurich, Switzerland.
authors.forename: Nicole
authors.initials: N
authors.lastname: Borel
authors.affiliation: Department of Medical Imaging, University Hospital Zurich, Raemistrasse 100, 8006, Zurich, Switzerland.
authors.forename: Paul
authors.initials: P
authors.lastname: Stolzmann
authors.affiliation: Swiss Light Source, Paul Scherrer Institute, 5232, Villigen-PSI, Switzerland.
authors.forename: Alberto
authors.initials: A
authors.lastname: Astolfo
authors.affiliation: Institute for Biomedical Engineering, and Center for Neuroscience Research, University and ETH Zurich ETH Zurich, Wolfgang-Pauli-Str. 27, 8093, Zurich, Switzerland.
authors.forename: Jan
authors.initials: J
authors.lastname: Klohs
authors.affiliation: Swiss Light Source, Paul Scherrer Institute, 5232, Villigen-PSI, Switzerland.
authors.forename: Marco
authors.initials: M
authors.lastname: Stampanoni
authors.affiliation: Institute for Biomedical Engineering, and Center for Neuroscience Research, University and ETH Zurich ETH Zurich, Wolfgang-Pauli-Str. 27, 8093, Zurich, Switzerland.
authors.forename: Markus
authors.initials: M
authors.lastname: Rudin
authors.affiliation: Department of Chemistry and Applied Biosciences of ETH Zurich, Center for Radiopharmaceutical Sciences ETH-PSI-USZ, Vladimir-Prelog-Weg 1-5/10, 8093, Zurich, Switzerland.
authors.forename: Roger
authors.initials: R
authors.lastname: Schibli
authors.affiliation: Department of Chemistry and Applied Biosciences of ETH Zurich, Center for Radiopharmaceutical Sciences ETH-PSI-USZ, Vladimir-Prelog-Weg 1-5/10, 8093, Zurich, Switzerland.
authors.forename: Stefanie D
authors.initials: SD
authors.lastname: Krämer
authors.affiliation: Department of Chemistry and Applied Biosciences of ETH Zurich, Center for Radiopharmaceutical Sciences ETH-PSI-USZ, Vladimir-Prelog-Weg 1-5/10, 8093, Zurich, Switzerland. adrienne.herde@pharma.ethz.ch.
authors.forename: Adrienne Müller
authors.initials: AM
authors.lastname: Herde
mesh_terms: D000368:Aged; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D016894:Endarterectomy, Carotid; D005240:Feasibility Studies; D005355:Fibrosis; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008297:Male; D009336:Necrosis; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D014056:Tomography, X-Ray / Q000379:methods*; D061205:Vascular Calcification / Q000175:diagnosis
keywords: Atherosclerosis; Carotid plaque; Differential phase contrast; Magnetic resonance imaging; Synchrotron; X-rays