title: 3D black blood VISTA vessel wall cardiovascular magnetic resonance of the thoracic aorta wall in young, healthy adults: reproducibility and implications for efficacy trial sample sizes: a cross-sectional study.
abstract: BACKGROUND
  Pre-clinical detection of atherosclerosis enables personalized preventive strategies in asymptomatic individuals. Cardiovascular magnetic resonance (CMR) has evolved as an attractive imaging modality for studying atherosclerosis in vivo. Yet, the majority of aortic CMR studies and proposed sequences to date have been performed at 1.5 tesla using 2D BB techniques and a slice thickness of 4-5 mm. Here, we evaluate for the first time the reproducibility of an isotropic, T1-weighted, three-dimensional, black-blood, CMR VISTA sequence (3D-T1-BB-VISTA) for quantification of aortic wall characteristics in healthy, young adults.
  
  
  METHODS
  In 20 healthy, young adults (10 males, mean age 31.3 years) of the AMBITYON cohort study the descending thoracic aorta was imaged with a 3.0 T MR system using the 3D-T1-BB-VISTA sequence. The inter-scan, inter-rater and intra-rater reproducibility of aortic lumen, total vessel and wall area and mean and maximum wall thickness was evaluated using Bland-Altman analyses and Intraclass Correlation Coefficients (ICC). Based on these findings, sample sizes for detecting differences in aortic wall characteristics between groups were calculated.
  
  
  RESULTS
  For each studied parameter, the inter-scan, inter-rater and intra-rater reproducibility was excellent as indicated by narrow limits of agreement and high ICCs (ranging from 0.76 to 0.99). Sample sizes required to detect a 5% difference in aortic wall characteristics between two groups were 203, 126, 136, 68 and 153 per group for lumen area, total vessel area and vessel wall area and for mean and maximum vessel wall thickness, respectively.
  
  
  CONCLUSIONS
  The 3D-T1-BB-VISTA sequence provides excellent reproducibility for quantification of aortic wall characteristics and can detect small differences between groups with reasonable sample sizes. Hence, it may be a valuable tool for assessment of the subtle vascular wall changes of early atherosclerosis in asymptomatic populations.
authors.affiliation: Department of Radiology (E01.132), University Medical Center, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands. a.l.m.eikendal@umcutrecht.nl.
authors.forename: Anouk L M
authors.initials: AL
authors.lastname: Eikendal
authors.affiliation: Department of Radiology (E01.132), University Medical Center, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
authors.forename: Björn A
authors.initials: BA
authors.lastname: Blomberg
authors.affiliation: Department of Radiology (E01.132), University Medical Center, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
authors.forename: Cees
authors.initials: C
authors.lastname: Haaring
authors.affiliation: Institute of Clinical Radiology, Ludwig-Maximilians-University Hospital, Marchioninistrasse 15, 81377, Munich, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Saam
authors.affiliation: Division of Image Processing, Department of Radiology, 1-C2S Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands.
authors.forename: Rob J
authors.initials: RJ
authors.lastname: van der Geest
authors.affiliation: Department of Radiology (E01.132), University Medical Center, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.|Philips Healthcare, Veenpluis 4-6, 5684PC, Best, The Netherlands.
authors.forename: Fredy
authors.initials: F
authors.lastname: Visser
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
authors.forename: Michiel L
authors.initials: ML
authors.lastname: Bots
authors.affiliation: Laboratory of Experimental Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
authors.forename: Hester M
authors.initials: HM
authors.lastname: den Ruijter
authors.affiliation: Laboratory of Clinical Chemistry and Hematology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
authors.forename: Imo E
authors.initials: IE
authors.lastname: Hoefer
authors.affiliation: Department of Radiology (E01.132), University Medical Center, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
authors.forename: Tim
authors.initials: T
authors.lastname: Leiner
mesh_terms: D000328:Adult; D001013:Aorta, Thoracic / Q000033:anatomy & histology*; D001027:Aortography / Q000379:methods*; D002986:Clinical Trials as Topic / Q000379:methods*; D003430:Cross-Sectional Studies; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D015588:Observer Variation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D018401:Sample Size; D055815:Young Adult
keywords: 3D; Aorta; Atherosclerosis; Black-blood; CMR; Characteristics; Healthy; Reproducibility; Young