1
|
Wang X, Nai YH, Gan J, Lian CPL, Ryan FK, Tan FSL, Chan DYS, Ng JJ, Lo ZJ, Chong TT, Hausenloy DJ. Multi-Modality Imaging of Atheromatous Plaques in Peripheral Arterial Disease: Integrating Molecular and Imaging Markers. Int J Mol Sci 2023; 24:11123. [PMID: 37446302 DOI: 10.3390/ijms241311123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/14/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Peripheral artery disease (PAD) is a common and debilitating condition characterized by the narrowing of the limb arteries, primarily due to atherosclerosis. Non-invasive multi-modality imaging approaches using computed tomography (CT), magnetic resonance imaging (MRI), and nuclear imaging have emerged as valuable tools for assessing PAD atheromatous plaques and vessel walls. This review provides an overview of these different imaging techniques, their advantages, limitations, and recent advancements. In addition, this review highlights the importance of molecular markers, including those related to inflammation, endothelial dysfunction, and oxidative stress, in PAD pathophysiology. The potential of integrating molecular and imaging markers for an improved understanding of PAD is also discussed. Despite the promise of this integrative approach, there remain several challenges, including technical limitations in imaging modalities and the need for novel molecular marker discovery and validation. Addressing these challenges and embracing future directions in the field will be essential for maximizing the potential of molecular and imaging markers for improving PAD patient outcomes.
Collapse
Affiliation(s)
- Xiaomeng Wang
- Cardiovascular & Metabolic Disorders Program, Duke-National University of Singapore Medical School, Singapore 169857, Singapore
| | - Ying-Hwey Nai
- Clinical Imaging Research Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117599, Singapore
| | - Julian Gan
- Siemens Healthineers, Singapore 348615, Singapore
| | - Cheryl Pei Ling Lian
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore 138683, Singapore
| | - Fraser Kirwan Ryan
- Infocomm Technology Cluster, Singapore Institute of Technology, Singapore 138683, Singapore
| | - Forest Su Lim Tan
- Infocomm Technology Cluster, Singapore Institute of Technology, Singapore 138683, Singapore
| | - Dexter Yak Seng Chan
- Department of General Surgery, Khoo Teck Puat Hospital, Singapore 768828, Singapore
| | - Jun Jie Ng
- Division of Vascular and Endovascular Surgery, Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre, Singapore 119074, Singapore
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Zhiwen Joseph Lo
- Vascular Surgery Service, Department of Surgery, Woodlands Health, Singapore 258499, Singapore
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
| | - Tze Tec Chong
- Department of Vascular Surgery, Singapore General Hospital, Singapore 168752, Singapore
- Surgical Academic Clinical Programme, Singapore General Hospital, Singapore 169608, Singapore
- Vascular SingHealth Duke-NUS Disease Centre, Singapore 168752, Singapore
| | - Derek John Hausenloy
- Cardiovascular & Metabolic Disorders Program, Duke-National University of Singapore Medical School, Singapore 169857, Singapore
- National Heart Research Institute Singapore, National Heart Centre, Singapore 169609, Singapore
- Yong Loo Lin School of Medicine, National University Singapore, Singapore 117597, Singapore
- The Hatter Cardiovascular Institute, University College London, London WC1E 6HX, UK
| |
Collapse
|
2
|
Guidi L, Lareyre F, Chaudhuri A, Cong Duy L, Adam C, Carrier M, Réda HK, Elixène JB, Raffort J. Automatic measurement of vascular calcifications in patients with aorto-iliac occlusive disease to predict the risk of re-intervention after endovascular repair. Ann Vasc Surg 2022; 83:10-19. [PMID: 35271959 DOI: 10.1016/j.avsg.2022.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 02/03/2022] [Accepted: 02/05/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE There is currently a lack of consensus and tools to easily measure vascular calcification using computed tomography angiography (CTA). The aim of this study was to develop a fully automatic software to measure calcifications and to evaluate the interest as predictive factor in patients with aorto-iliac occlusive disease. METHODS This study retrospectively included 171 patients who had endovascular repair of an aorto-iliac occlusive lesion at the University Hospital of Nice between January 2011 and December 2019. Calcifications volumes were measured from CT-angiography (CTA) using an automatic method consisting in 3 sequential steps: image pre-processing, lumen segmentation using expert system and deep learning algorithms and segmentation of calcifications. Calcification volumes were measured in the infrarenal abdominal aorta and the iliac arterial segments, corresponding to the common and the external iliac arteries. RESULTS Among 171 patients included with a mean age of 65 years, the revascularization was performed on the native external and internal iliac arteries in respectively: 83 patients (48.5%); 107 (62.3%) and 7 (4.1%). The mean volumes of calcifications were 2759 mm3 in the infrarenal abdominal aorta, 1821 mm3 and 1795 mm3 in the right and left iliac arteries. For a mean follow up of 39 months, TLR was performed in 55 patients (32.2%). These patients had higher volume of calcifications in the right and left iliac arteries, compared with patients who did not have a re-intervention (2274 mm3 vs 1606 mm3, p=0.0319 and 2278 vs 1567 mm3, p=0.0213). CONCLUSION The development of a fully automatic software would be useful to facilitate the measurement of vascular calcifications and possibly better inform the prognosis of patients.
Collapse
Affiliation(s)
- Lucas Guidi
- Department of Vascular Surgery, University Hospital of Nice, France
| | - Fabien Lareyre
- Department of Vascular Surgery, Hospital of Antibes Juan-les-Pins, France; Université Côte d'Azur, Inserm U1065, C3M, Nice, France.
| | - Arindam Chaudhuri
- Bedfordshire-Milton Keynes Vascular Centre, Bedfordshire Hospitals NHS Foundation Trust, Bedford, UK
| | - Lê Cong Duy
- Department of Vascular Surgery, Hospital of Antibes Juan-les-Pins, France; Université Côte d'Azur, Inserm U1065, C3M, Nice, France
| | - Cédric Adam
- Laboratory of Applied Mathematics and Computer Science (MICS), CentraleSupélec, Université Paris-Saclay, France
| | - Marion Carrier
- Laboratory of Applied Mathematics and Computer Science (MICS), CentraleSupélec, Université Paris-Saclay, France
| | | | | | - Juliette Raffort
- Université Côte d'Azur, Inserm U1065, C3M, Nice, France; Clinical Chemistry Laboratory, University Hospital of Nice, France; Institute 3IA Côte d'Azur, Université Côte d'Azur, France
| |
Collapse
|
3
|
Cahalane RM, O'Brien JM, Kavanagh EG, Moloney MA, Leahy FC, Walsh MT. Correlating Ex Vivo Carotid Calcification Measurements With Cerebrovascular Symptoms: A Proof-of-Concept Study. Stroke 2020; 51:e250-e253. [PMID: 32755345 DOI: 10.1161/strokeaha.120.029973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE The purpose of this study is to examine the ability of ex vivo derived Agatston, Volume, and Density-Volume calcium scores or calcium density measurements to differentiate between carotid plaques based on preoperative cerebrovascular symptomatology. METHODS Thirty-eight carotid plaques were acquired from standard endarterectomy. Micro-computed tomography was performed on the ex vivo samples. Image series were downsampled to represent the resolution of clinical multidetector computed tomography. Agatston, Volume, and Density-Volume carotid calcium scores were then calculated using coronary methodologies. The fractions of low- and high-density calcification were also determined. RESULTS The coronary calcium scores could not differentiate between carotid plaques from asymptomatic versus symptomatic patients. However, plaques from asymptomatic patients contained significantly lower fractions of low-density calcification and higher fractions of high-density calcification. CONCLUSIONS Screening for carotid calcium density in noncontrast computed tomography could reflect plaque stability.
Collapse
Affiliation(s)
- Rachel M Cahalane
- BioScience and BioEngineering Research, Biomaterials Cluster, Bernal Institute, School of Engineering (R.M.C., M.T.W.), University of Limerick, Ireland
| | - Julie M O'Brien
- Department of Radiology (J.M.O.), University Hospital Limerick, Ireland
| | - Eamon G Kavanagh
- Department of Vascular Surgery (E.G.K., M.A.M.), University Hospital Limerick, Ireland
| | - Michael A Moloney
- Department of Vascular Surgery (E.G.K., M.A.M.), University Hospital Limerick, Ireland
| | - Fiona C Leahy
- Clinical Research Support Unit (F.C.L.), University Hospital Limerick, Ireland
| | - Michael T Walsh
- BioScience and BioEngineering Research, Biomaterials Cluster, Bernal Institute, School of Engineering (R.M.C., M.T.W.), University of Limerick, Ireland.,Health Research Institute (M.T.W.), University of Limerick, Ireland
| |
Collapse
|