Coronary Atherosclerosis T1-Weighed Characterization With Integrated Anatomical Reference: Comparison With High-Risk Plaque Features Detected by Invasive Coronary Imaging

Yibin Xie, Young Jin Kim, Jianing Pang, Jung Sun Kim, Qi Yang, Janet Wei, Christopher T. Nguyen, Zixin Deng, Byoung Wook Choi, Zhaoyang Fan, C. Noel Bairey Merz, Prediman K. Shah, Daniel S. Berman, Hyuk Jae Chang, Debiao Li

Research output: Contribution to journalArticle

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Abstract

Objectives The aim of this work is the development of coronary atherosclerosis T1-weighted characterization with integrated anatomical reference (CATCH) technique and the validation by comparison with high-risk plaque features (HRPF) observed on intracoronary optical coherence tomography (OCT) and invasive coronary angiography. Background T1-weighted cardiac magnetic resonance with or without contrast media has been used for characterizing coronary atherosclerosis showing promising prognostic value. Several limitations include: 1) coverage is limited to proximal coronary segments; 2) spatial resolution is low and often anisotropic; and 3) a separate magnetic resonance angiography acquisition is needed to localize lesions. Methods CATCH acquired dark-blood T1-weighted images and bright-blood anatomical reference images in an interleaved fashion. Retrospective motion correction with 100% respiratory gating efficiency was achieved. Reference control subjects (n = 13) completed both pre- and post-contrast scans. Stable angina patients (n = 30) completed pre-contrast scans, among whom 26 eligible patients also completed post-contrast scans. After cardiac magnetic resonance, eligible patients (n = 22) underwent invasive coronary angiography and OCT for the interrogation of coronary atherosclerosis. OCT images were assessed and scored for HRPF (lipid-richness, macrophages, cholesterol crystals, and microvessels) by 2 experienced analysts blinded to magnetic resonance results. Results Per-subject analysis showed none of the 13 reference control subjects had coronary hyperintensive plaques (CHIP) in either pre-contrast or post-contrast CATCH. Five patients had CHIP on pre-contrast CATCH and 5 patients had CHIP on post-contrast CATCH. Patients with CHIP had greater lipid abnormality than those without. Per-segment analysis showed elevated pre- and post-contrast plaque to myocardium signal ratio in the lesions with HRPF versus those without. Positive correlation was observed between plaque to myocardium signal ratio and OCT HRPF scoring. CHIP on pre-contrast CATCH were associated with significantly higher stenosis level than non-CHIP on invasive coronary angiography. Conclusions CATCH provided accelerated whole heart coronary plaque characterization with simultaneously acquired anatomical reference. CHIP detected by CATCH showed positive association with high-risk plaque features on invasive imaging studies.

Original languageEnglish
Pages (from-to)637-648
Number of pages12
JournalJACC: Cardiovascular Imaging
Volume10
Issue number6
DOIs
Publication statusPublished - 2017 Jun

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Coronary Artery Disease
Optical Coherence Tomography
Coronary Angiography
Magnetic Resonance Spectroscopy
Myocardium
Lipids
Stable Angina
Magnetic Resonance Angiography
Microvessels
Contrast Media
Pathologic Constriction
Macrophages
Cholesterol

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Xie, Yibin ; Kim, Young Jin ; Pang, Jianing ; Kim, Jung Sun ; Yang, Qi ; Wei, Janet ; Nguyen, Christopher T. ; Deng, Zixin ; Choi, Byoung Wook ; Fan, Zhaoyang ; Bairey Merz, C. Noel ; Shah, Prediman K. ; Berman, Daniel S. ; Chang, Hyuk Jae ; Li, Debiao. / Coronary Atherosclerosis T1-Weighed Characterization With Integrated Anatomical Reference : Comparison With High-Risk Plaque Features Detected by Invasive Coronary Imaging. In: JACC: Cardiovascular Imaging. 2017 ; Vol. 10, No. 6. pp. 637-648.
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title = "Coronary Atherosclerosis T1-Weighed Characterization With Integrated Anatomical Reference: Comparison With High-Risk Plaque Features Detected by Invasive Coronary Imaging",
abstract = "Objectives The aim of this work is the development of coronary atherosclerosis T1-weighted characterization with integrated anatomical reference (CATCH) technique and the validation by comparison with high-risk plaque features (HRPF) observed on intracoronary optical coherence tomography (OCT) and invasive coronary angiography. Background T1-weighted cardiac magnetic resonance with or without contrast media has been used for characterizing coronary atherosclerosis showing promising prognostic value. Several limitations include: 1) coverage is limited to proximal coronary segments; 2) spatial resolution is low and often anisotropic; and 3) a separate magnetic resonance angiography acquisition is needed to localize lesions. Methods CATCH acquired dark-blood T1-weighted images and bright-blood anatomical reference images in an interleaved fashion. Retrospective motion correction with 100{\%} respiratory gating efficiency was achieved. Reference control subjects (n = 13) completed both pre- and post-contrast scans. Stable angina patients (n = 30) completed pre-contrast scans, among whom 26 eligible patients also completed post-contrast scans. After cardiac magnetic resonance, eligible patients (n = 22) underwent invasive coronary angiography and OCT for the interrogation of coronary atherosclerosis. OCT images were assessed and scored for HRPF (lipid-richness, macrophages, cholesterol crystals, and microvessels) by 2 experienced analysts blinded to magnetic resonance results. Results Per-subject analysis showed none of the 13 reference control subjects had coronary hyperintensive plaques (CHIP) in either pre-contrast or post-contrast CATCH. Five patients had CHIP on pre-contrast CATCH and 5 patients had CHIP on post-contrast CATCH. Patients with CHIP had greater lipid abnormality than those without. Per-segment analysis showed elevated pre- and post-contrast plaque to myocardium signal ratio in the lesions with HRPF versus those without. Positive correlation was observed between plaque to myocardium signal ratio and OCT HRPF scoring. CHIP on pre-contrast CATCH were associated with significantly higher stenosis level than non-CHIP on invasive coronary angiography. Conclusions CATCH provided accelerated whole heart coronary plaque characterization with simultaneously acquired anatomical reference. CHIP detected by CATCH showed positive association with high-risk plaque features on invasive imaging studies.",
author = "Yibin Xie and Kim, {Young Jin} and Jianing Pang and Kim, {Jung Sun} and Qi Yang and Janet Wei and Nguyen, {Christopher T.} and Zixin Deng and Choi, {Byoung Wook} and Zhaoyang Fan and {Bairey Merz}, {C. Noel} and Shah, {Prediman K.} and Berman, {Daniel S.} and Chang, {Hyuk Jae} and Debiao Li",
year = "2017",
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Coronary Atherosclerosis T1-Weighed Characterization With Integrated Anatomical Reference : Comparison With High-Risk Plaque Features Detected by Invasive Coronary Imaging. / Xie, Yibin; Kim, Young Jin; Pang, Jianing; Kim, Jung Sun; Yang, Qi; Wei, Janet; Nguyen, Christopher T.; Deng, Zixin; Choi, Byoung Wook; Fan, Zhaoyang; Bairey Merz, C. Noel; Shah, Prediman K.; Berman, Daniel S.; Chang, Hyuk Jae; Li, Debiao.

In: JACC: Cardiovascular Imaging, Vol. 10, No. 6, 06.2017, p. 637-648.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Coronary Atherosclerosis T1-Weighed Characterization With Integrated Anatomical Reference

T2 - Comparison With High-Risk Plaque Features Detected by Invasive Coronary Imaging

AU - Xie, Yibin

AU - Kim, Young Jin

AU - Pang, Jianing

AU - Kim, Jung Sun

AU - Yang, Qi

AU - Wei, Janet

AU - Nguyen, Christopher T.

AU - Deng, Zixin

AU - Choi, Byoung Wook

AU - Fan, Zhaoyang

AU - Bairey Merz, C. Noel

AU - Shah, Prediman K.

AU - Berman, Daniel S.

AU - Chang, Hyuk Jae

AU - Li, Debiao

PY - 2017/6

Y1 - 2017/6

N2 - Objectives The aim of this work is the development of coronary atherosclerosis T1-weighted characterization with integrated anatomical reference (CATCH) technique and the validation by comparison with high-risk plaque features (HRPF) observed on intracoronary optical coherence tomography (OCT) and invasive coronary angiography. Background T1-weighted cardiac magnetic resonance with or without contrast media has been used for characterizing coronary atherosclerosis showing promising prognostic value. Several limitations include: 1) coverage is limited to proximal coronary segments; 2) spatial resolution is low and often anisotropic; and 3) a separate magnetic resonance angiography acquisition is needed to localize lesions. Methods CATCH acquired dark-blood T1-weighted images and bright-blood anatomical reference images in an interleaved fashion. Retrospective motion correction with 100% respiratory gating efficiency was achieved. Reference control subjects (n = 13) completed both pre- and post-contrast scans. Stable angina patients (n = 30) completed pre-contrast scans, among whom 26 eligible patients also completed post-contrast scans. After cardiac magnetic resonance, eligible patients (n = 22) underwent invasive coronary angiography and OCT for the interrogation of coronary atherosclerosis. OCT images were assessed and scored for HRPF (lipid-richness, macrophages, cholesterol crystals, and microvessels) by 2 experienced analysts blinded to magnetic resonance results. Results Per-subject analysis showed none of the 13 reference control subjects had coronary hyperintensive plaques (CHIP) in either pre-contrast or post-contrast CATCH. Five patients had CHIP on pre-contrast CATCH and 5 patients had CHIP on post-contrast CATCH. Patients with CHIP had greater lipid abnormality than those without. Per-segment analysis showed elevated pre- and post-contrast plaque to myocardium signal ratio in the lesions with HRPF versus those without. Positive correlation was observed between plaque to myocardium signal ratio and OCT HRPF scoring. CHIP on pre-contrast CATCH were associated with significantly higher stenosis level than non-CHIP on invasive coronary angiography. Conclusions CATCH provided accelerated whole heart coronary plaque characterization with simultaneously acquired anatomical reference. CHIP detected by CATCH showed positive association with high-risk plaque features on invasive imaging studies.

AB - Objectives The aim of this work is the development of coronary atherosclerosis T1-weighted characterization with integrated anatomical reference (CATCH) technique and the validation by comparison with high-risk plaque features (HRPF) observed on intracoronary optical coherence tomography (OCT) and invasive coronary angiography. Background T1-weighted cardiac magnetic resonance with or without contrast media has been used for characterizing coronary atherosclerosis showing promising prognostic value. Several limitations include: 1) coverage is limited to proximal coronary segments; 2) spatial resolution is low and often anisotropic; and 3) a separate magnetic resonance angiography acquisition is needed to localize lesions. Methods CATCH acquired dark-blood T1-weighted images and bright-blood anatomical reference images in an interleaved fashion. Retrospective motion correction with 100% respiratory gating efficiency was achieved. Reference control subjects (n = 13) completed both pre- and post-contrast scans. Stable angina patients (n = 30) completed pre-contrast scans, among whom 26 eligible patients also completed post-contrast scans. After cardiac magnetic resonance, eligible patients (n = 22) underwent invasive coronary angiography and OCT for the interrogation of coronary atherosclerosis. OCT images were assessed and scored for HRPF (lipid-richness, macrophages, cholesterol crystals, and microvessels) by 2 experienced analysts blinded to magnetic resonance results. Results Per-subject analysis showed none of the 13 reference control subjects had coronary hyperintensive plaques (CHIP) in either pre-contrast or post-contrast CATCH. Five patients had CHIP on pre-contrast CATCH and 5 patients had CHIP on post-contrast CATCH. Patients with CHIP had greater lipid abnormality than those without. Per-segment analysis showed elevated pre- and post-contrast plaque to myocardium signal ratio in the lesions with HRPF versus those without. Positive correlation was observed between plaque to myocardium signal ratio and OCT HRPF scoring. CHIP on pre-contrast CATCH were associated with significantly higher stenosis level than non-CHIP on invasive coronary angiography. Conclusions CATCH provided accelerated whole heart coronary plaque characterization with simultaneously acquired anatomical reference. CHIP detected by CATCH showed positive association with high-risk plaque features on invasive imaging studies.

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