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Lobbes, M.B.I.; Heeneman, S.; Passos, V.L.; Welten, R.; Kwee, R.M.; Geest, R.J. van der; ... ; Kooi, M.E. (2010)

Gadofosveset-Enhanced Magnetic Resonance Imaging of Human Carotid Atherosclerotic Plaques A Proof-of-Concept Study

Article / Letter to editor
Objective: To investigate the potential of gadofosveset-enhanced MR imaging for the characterization of human carotid atherosclerotic plaques. Materials and Methods: Sixteen (9 symptomatic, 7 asymptomatic) patients with 70% to 99% carotid stenosis (according to NASCET criteria) were included (13 men, 3 women, mean age 67.6 years). All patients underwent baseline precontrast MR imaging of the carotid plaque. Immediately after completion of the baseline examination, 0.03 mmol/kg gadofosveset was administered. At 24 hours postinjection, the acquisition was repeated. Twelve patients were scheduled for carotid endarterectomy. Carotid endarterectomy specimens were HE-, CD31-, CD68-, and albumin-stained to correlate signal enhancement with plaque composition, intraplaque microvessel density, and macrophage and albumin content. A random intercept model was used to compare signal enhancement between symptomatic and asymptomatic patients, adjusting for size of various plaque components. This...Show moreObjective: To investigate the potential of gadofosveset-enhanced MR imaging for the characterization of human carotid atherosclerotic plaques. Materials and Methods: Sixteen (9 symptomatic, 7 asymptomatic) patients with 70% to 99% carotid stenosis (according to NASCET criteria) were included (13 men, 3 women, mean age 67.6 years). All patients underwent baseline precontrast MR imaging of the carotid plaque. Immediately after completion of the baseline examination, 0.03 mmol/kg gadofosveset was administered. At 24 hours postinjection, the acquisition was repeated. Twelve patients were scheduled for carotid endarterectomy. Carotid endarterectomy specimens were HE-, CD31-, CD68-, and albumin-stained to correlate signal enhancement with plaque composition, intraplaque microvessel density, and macrophage and albumin content. A random intercept model was used to compare signal enhancement between symptomatic and asymptomatic patients, adjusting for size of various plaque components. This study was approved by the institutional medical ethics committee. All participants gave written informed consent. Results: Signal enhancement (SE) of the plaque was significantly higher in symptomatic patients compared with asymptomatic patients (median log SE 0.182 vs. -0.109, respectively, P < 0.001). A positive association (as expressed by a regression coefficient beta = 0.0035) was found between signal enhancement on the log scale and intraplaque albumin content (P = 0.038). There was no association between signal enhancement and various other plaque components. Conclusion: In this study, the potential of gadofosveset-enhanced human carotid plaque MR imaging for identification of high-risk plaques was demonstrated. Signal enhancement of the plaque after administration of gadofosveset was associated with differences in intraplaque albumin content. Although promising, we emphasize that these results are based on a small patient population. Larger prospective studies are warranted.Show less
magnetic resonance imaging atherosclerosis carotid arteries contrast agents intravascular contrast agent gadofosveset pool contrast agent mr-angiography gadopentetate dimeglumine microvessels albumin stenosis lesions ms-325 wall
All authors
Lobbes, M.B.I.; Heeneman, S.; Passos, V.L.; Welten, R.; Kwee, R.M.; Geest, R.J. van der; Wiethoff, A.J.; Caravan, P.; Misselwitz, B.; Daemen, M.J.A.P.; Engelshoven, J.M.A. van; Leiner, T.; Kooi, M.E.
Date
2010-05-31
Journal
Investigative Radiology
Volume
45
Issue
5
Pages
275 - 281
DOI
doi:10.1097/RLI.0b013e3181d5466b