Quantification of human atherosclerotic plaques using spatially enhanced cluster analysis of multicontrast‐weighted magnetic resonance images

One of the current limitations of magnetic resonance imaging (MRI) is the lack of an objective method to classify plaque components. Here we present a cluster analysis technique that can objectively quantify and classify MR images of atherosclerotic plaques. We obtained three‐dimensional (3D) images from 12 human coronary artery specimens on a 9.4T imaging system using multicontrast‐weighted fast spin‐echo (T1‐, proton density‐, and T2‐weighted) imaging with an isotropic voxel size of 39 μ. Spatially enhanced cluster analysis (SECA) was performed on multicontrast MR images, and the resulting segmentation was evaluated against histological tracings. To visualize the overall structure of plaques, the MR images were rendered in 3D. The specimens exhibited lesions of American Heart Association (AHA) plaque classification types I‐VI. Both MR images and histological sections were independently reviewed, categorized, and compared. Overall, the classification obtained from the cluster‐analyzed MR and histopathology images showed very good agreement for all AHA types (92%, Cohen's κ = 0.89, P < 0.0001). All plaque types were identified and quantified by SECA with a high degree of correlation between cluster‐analyzed MR and manually traced histopathology data. MRI combined with SECA provides an objective method for atherosclerotic plaque component characterization and quantification. Magn Reson Med 52:515–523, 2004. © 2004 Wiley‐Liss, Inc.

[1]  E. Forgy Cluster analysis of multivariate data : efficiency versus interpretability of classifications , 1965 .

[2]  J R Brookeman,et al.  Image analysis and quantification of atherosclerosis using MRI. , 1991, Computerized medical imaging and graphics : the official journal of the Computerized Medical Imaging Society.

[3]  W. Garvey Modified elastic tissue-Masson trichrome stain. , 1984, Stain technology.

[4]  James Theiler,et al.  Contiguity-enhanced k-means clustering algorithm for unsupervised multispectral image segmentation , 1997, Optics & Photonics.

[5]  E Falk,et al.  Effects of temperature and histopathologic preparation on the size and morphology of atherosclerotic carotid arteries as imaged by MRI , 1999, Journal of magnetic resonance imaging : JMRI.

[6]  V. Fuster,et al.  High resolution ex vivo magnetic resonance imaging of in situ coronary and aortic atherosclerotic plaque in a porcine model. , 2000, Atherosclerosis.

[7]  Chun Yuan,et al.  In vivo accuracy of multisequence MR imaging for identifying unstable fibrous caps in advanced human carotid plaques , 2003, Journal of magnetic resonance imaging : JMRI.

[8]  P. Libby,et al.  MRI of rabbit atherosclerosis in response to dietary cholesterol lowering. , 1999, Arteriosclerosis, thrombosis, and vascular biology.

[9]  M. J. Mitchinson,et al.  Insoluble lipids in human atherosclerotic plaques. , 1982, Atherosclerosis.

[10]  Scott T. Grafton,et al.  Automated image registration: I. General methods and intrasubject, intramodality validation. , 1998, Journal of computer assisted tomography.

[11]  W D Wagner,et al.  A definition of advanced types of atherosclerotic lesions and a histological classification of atherosclerosis. A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. , 1995, Arteriosclerosis, thrombosis, and vascular biology.

[12]  C Yuan,et al.  Measurement of atherosclerotic carotid plaque size in vivo using high resolution magnetic resonance imaging. , 1998, Circulation.

[13]  V. Fuster,et al.  Lipid Lowering by Simvastatin Induces Regression of Human Atherosclerotic Lesions: Two Years’ Follow-Up by High-Resolution Noninvasive Magnetic Resonance Imaging , 2002, Circulation.

[14]  Chun Yuan,et al.  Classification of Human Carotid Atherosclerotic Lesions With In Vivo Multicontrast Magnetic Resonance Imaging , 2002, Circulation.

[15]  V. Fuster,et al.  Magnetic resonance images lipid, fibrous, calcified, hemorrhagic, and thrombotic components of human atherosclerosis in vivo. , 1996, Circulation.

[16]  W S Kerwin,et al.  In Vivo Accuracy of Multispectral Magnetic Resonance Imaging for Identifying Lipid-Rich Necrotic Cores and Intraplaque Hemorrhage in Advanced Human Carotid Plaques , 2001, Circulation.

[17]  R. Balaban,et al.  Carotid artery atherosclerosis: in vivo morphologic characterization with gadolinium-enhanced double-oblique MR imaging initial results. , 2002, Radiology.

[18]  W J Rogers,et al.  Characterization of signal properties in atherosclerotic plaque components by intravascular MRI. , 2000, Arteriosclerosis, thrombosis, and vascular biology.

[19]  V. Fuster,et al.  In vivo magnetic resonance evaluation of atherosclerotic plaques in the human thoracic aorta: a comparison with transesophageal echocardiography. , 2000, Circulation.

[20]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.

[21]  V. Fuster,et al.  Clinical Imaging of the High-Risk or Vulnerable Atherosclerotic Plaque , 2001, Circulation research.

[22]  G. Johnson,et al.  Magnetic Resonance Microscopy of the C57BL Mouse Brain , 2000, NeuroImage.

[23]  V. Fuster,et al.  The diagnostic accuracy of ex vivo MRI for human atherosclerotic plaque characterization. , 1999, Arteriosclerosis, thrombosis, and vascular biology.