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ImmunoSERS microscopy for the detection of smooth muscle cells in atherosclerotic plaques
摘要： We investigated the suitability of immuno-SERS (iSERS) microscopy for imaging of smooth muscle cells (SMCs) in atherosclerotic plaques. Localization of SMCs is achieved by using SERS-labelled antibodies direct against alpha-smooth muscle actin (SMA). The staining quality of the false-colour iSERS images obtained by confocal Raman microscopy with point mapping is compared with wide-field immunofluorescence images. Both direct (labelled primary antibody) and indirect iSERS staining (unlabelled primary and labelled secondary antibody) techniques were employed. Direct iSERS staining yields results comparable to indirect IF staining, demonstrating the suitability of iSERS in research on atherosclerosis and paving the way for future multiplexed imaging experiments.
关键词： ImmunoSERS microscopy,Smooth muscle cells (SMCs),Atherosclerosis,Direct/indirect staining
更新于2025-11-21 11:24:58
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Small HDL subclass is associated with coronary plaque stability: An optical coherence tomography study in patients with coronary artery disease
摘要： BACKGROUND: The role of high-density lipoprotein (HDL) subclasses in atherosclerotic diseases remains an open question. Previous clinical trials have attempted to explore the predictive effect of HDL subspecies on cardiovascular risk. However, no studies have assessed the connections between these subclasses and characteristics of plaque microstructure. OBJECTIVE: To investigate the relationship of HDL subclasses and coronary plaque stability assessed by optical coherence tomography (OCT). METHODS: Morphological characteristics of 160 nontarget lesions from 85 patients with coronary artery disease were assessed by OCT. HDL subclass profiles were analyzed using nondenaturing polyacrylamide gel electrophoresis. RESULTS: The plasma levels of small HDL subclass (percentage or concentration) were found to be positively associated with fibrous cap thickness (r = 0.232, P = .007; r = 0.243, P = .005) and negatively with maximum lipid arc (r = -0.240, P = .005; r = -0.252, P = .003) and lipid core length (r = -0.350, P < .001; r = -0.367, P < .001). Multivariate logistic regression analysis showed the small HDL subclass (percentage or concentration) (odds ratio [OR]: 0.457, 95% confidence interval [CI]: 0.214–0.974, P = .043; OR: 0.438, 95% CI: 0.204–0.938, P = .034) to be an independent factor in predicting OCT-detected thin-cap fibroatheroma of nontarget lesions. CONCLUSION: High levels of small HDL are associated with coronary nontarget plaque stability. Our findings suggest that the small HDL subtype might represent the atheroprotective activity of HDL.
关键词： Atherosclerosis,High-density lipoprotein,Optical coherence tomography,Plaque stability
更新于2025-09-23 15:23:52
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Submillisievert CT angiography for carotid arteries using wide array CT scanner and latest iterative reconstruction algorithm in comparison with previous generations technologies: Feasibility and diagnostic accuracy
摘要： Objectives: To assess evaluability and diagnostic accuracy of a low dose CT angiography (CTA) protocol for carotid arteries using latest Iterative Reconstruction (IR) algorithm in comparison with standard 100 kVp protocol using previous generation CT and IR. Materials and Methods: 105 patients, referred for CTA of the carotid arteries were prospectively enrolled in our study and underwent CTA with 80 kVp and latest IR algorithm (group 1). Data were retrospectively compared with 100 consecutive patients with similar examination indications that had previously undergone CTA of carotid arteries with a standard 100 kVp protocol and a first generation IR algorithm (group 2). Image quality was evaluated with a 4-point Likert-scale. For each exam CT number, image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) at level of common carotid artery (CCA), internal carotid artery (ICA) and at level of Circle of Willis and Effective Dose (ED) were evaluated. 62 Group 1 patients underwent a clinically indicated DSA and results were compared with CTA. Results: No exams reported as not diagnostic. The overall mean CT number value of all arterial segments was above 450 HU in both groups. Significant lower noise, and higher SNR and CNR values were found in group 1 in comparison with group 2 despite the use of 80 kVp. In 62-group 1 patients studied by DSA, CTA showed in a segment-based analysis a sensitivity, negative predictive value and accuracy of 100%, 100% and 99% respectively. Mean ED in group 1 was 0.54±0.1 mSv with a dose reduction up to 86%. Conclusions: CTA for carotid arteries using latest IR algorithm allows to perform exams with submillisievert radiation exposure maintaining good image quality, overall evaluability and diagnostic accuracy.
关键词： atherosclerosis,Carotid arteries,Computed Tomography Angiography,Iterative reconstruction algorithm.,dose reduction
更新于2025-09-23 15:22:29
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<sup>18</sup> F-Sodium Fluoride Positron Emission Tomography and Plaque Calcification
摘要： 18F-sodium fluoride (18F-NaF) was introduced as a tracer for imaging skeletal diseases in 1962 and was approved by the Food and Drug Administration in 1972.1 Recently, with the increased availability of positron emission tomography (PET) scanners there has been a surge in clinical utilization of 18F-NaF imaging for oncological applications. The incidental observation, nearly a decade ago, of 18F-NaF uptake in the vasculature in patients undergoing PET imaging for cancer has led to a growing number of investigations exploring the potential role of this tracer in atherosclerosis.2–4 However, the biological correlates of 18F-NaF imaging in the vasculature, and its potential role in risk stratification of patients and prospective identification of vulnerable plaques remain incompletely characterized. In this issue of the Journal, Creager et al5 address some of these gaps by exploring the relationship between 18F-NaF binding and the size of microcalcifications using a 3-dimensional hydrogel platform.6 In agreement with a previous publication,2 their study finds that smaller and more numerous microcalcifications (ie, higher surface areas of calcifications) are associated with higher 18F-NaF binding when compared with fewer larger calcifications.5 The study also provides ex vivo proof-of-concept evidence for the correlation between 18F-NaF binding and foci of ongoing calcification in mouse and human atherosclerotic plaques.5
关键词： Editorials,sodium fluoride,atherosclerosis,inflammation,positron emission tomography
更新于2025-09-23 15:22:29
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Receive Beam-Steering and Clutter Reduction for Imaging the Speed-of-Sound Inside the Carotid Artery
摘要： Handheld imaging of the tissue’s speed-of-sound (SoS) is a promising multimodal addition to diagnostic ultrasonography for the examination of tissue composition. Computed ultrasound tomography in echo mode (CUTE) probes the spatial distribution of SoS, conventionally via scanning the tissue under a varying angle of ultrasound transmission, and quantifying—in a spatially resolved way—phase variations of the beamformed echoes. So far, this technique is not applicable to imaging the lumen of vessels, where blood ?ow and tissue clutter inhibit phase tracking of the blood echoes. With the goal to enable the assessment of atherosclerotic plaque composition inside the carotid artery, we propose two modi?cations to CUTE: (a) use receive (Rx) beam-steering as opposed to transmit (Tx) beam-steering to increase acquisition speed and to reduce ?ow-related phase decorrelation, and (b) conduct pairwise subtraction of data obtained from repetitions of the scan sequence, to highlight blood echoes relative to static echo clutter and thus enable the phase tracking of blood echoes. These modi?cations were tested in a phantom study, where the echogenicity of the vessel lumen was chosen to be similar to the one of the background medium, which allows a direct comparison of SoS images obtained with the different techniques. Our results demonstrate that the combination of Rx-steering with the subtraction technique results in an SoS image of the same quality as obtained with conventional Tx-steering. Together with the improved acquisition speed, this makes the proposed technique a key step towards successful imaging of the SoS inside the carotid artery.
关键词： atherosclerosis,clutter reduction,plaque characterisation,multimodal imaging,ultrasound tomography
更新于2025-09-23 15:22:29
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<sup>18</sup> F-Fluoride Signal Amplification Identifies Microcalcifications Associated With Atherosclerotic Plaque Instability in Positron Emission Tomography/Computed Tomography Images
摘要： BACKGROUND: Microcalcifications in atherosclerotic plaques are destabilizing, predict adverse cardiovascular events, and are associated with increased morbidity and mortality. 18F-fluoride positron emission tomography (PET)/computed tomography (CT) imaging has demonstrated promise as a useful clinical diagnostic tool in identifying high-risk plaques; however, there is confusion as to the underlying mechanism of signal amplification seen in PET-positive, CT-negative image regions. This study tested the hypothesis that 18F-fluoride PET/CT can identify early microcalcifications. METHODS: 18F-fluoride signal amplification derived from microcalcifications was validated against near-infrared fluorescence molecular imaging and histology using an in vitro 3-dimensional hydrogel collagen platform, ex vivo human specimens, and a mouse model of atherosclerosis. RESULTS: Microcalcification size correlated inversely with collagen concentration. The 18F-fluoride ligand bound to microcalcifications formed by calcifying vascular smooth muscle cell derived extracellular vesicles in the in vitro 3-dimensional collagen system and exhibited an increasing signal with an increase in collagen concentration (0.25 mg/mL collagen ?33.8×102±12.4×102 counts per minute; 0.5 mg/mL collagen ?67.7×102±37.4×102 counts per minute; P=0.0014), suggesting amplification of the PET signal by smaller microcalcifications. We further incubated human atherosclerotic endarterectomy specimens with clinically relevant concentrations of 18F-fluoride. The 18F-fluoride ligand labeled microcalcifications in PET-positive, CT-negative regions of explanted human specimens as evidenced by 18F-fluoride PET/CT imaging, near-infrared fluorescence, and histological analysis. Additionally, the 18F-fluoride ligand identified micro and macrocalcifications in atherosclerotic aortas obtained from low-density lipoprotein receptor-deficient mice. CONCLUSIONS: Our results suggest that 18F-fluoride PET signal in PET-positive, CT-negative regions of human atherosclerotic plaques is the result of developing microcalcifications, and high surface area in regions of small microcalcifications may amplify PET signal.
关键词： molecular imaging,fluoride,atherosclerosis,positron emission tomography,microcalcification
更新于2025-09-23 15:22:29
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How to Utilize Coronary Computed Tomography Angiography in the Treatment of Coronary Artery Disease
摘要： Coronary computed tomography angiography (CCTA) has high negative predictive power for detecting coronary artery disease. However CCTA is limited by moderate positive predictive power in the detection of myocardial ischemia. This is not unexpected because the diameter of a stenosis is a poor indicator of myocardial ischemia and discrepancy between the severity of stenosis and noninvasive tests is not uncommon. The value of stenosis for predicting future development of acute coronary syndrome represented by plaque rupture has been questioned. CCTA identifies the characteristics of high-risk plaque including positive remodeling, low density plaque and spotty or micro-calcification. Also, additional evaluation of myocardial ischemia using computational flow dynamics, and luminal attenuation gradient are expected to increase both diagnostic performance for hemodynamically significant stenosis and the predictive power for future cardiovascular risk. Technical advances in CCTA would enable evaluation of both coronary artery stenosis and myocardial ischemia simultaneously with high predictive performance, and would improve vastly the clinical value of CCTA.
关键词： Functional ischemia,Coronary artery disease,Atherosclerosis,Prognosis,Coronary CT angiography,Myocardial mass
更新于2025-09-23 15:22:29
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Computed Tomography of Acquired Aortic Diseases
摘要： Computed tomography angiography (CTA) has replaced catheter angiography in the evaluation of aortic disease. CTA is able to evaluate occlusive and aneurysmal disease of the aorta. Inflammatory conditions of the aorta can also be assessed with CTA.
关键词： Aortitis,CTA,Aorta,Atherosclerosis,Aortic aneurysm
更新于2025-09-23 15:21:01
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Pulse Wave Imaging in Carotid Artery Stenosis Human Patients in Vivo
摘要： Carotid stenosis involves narrowing of the lumen in the carotid artery potentially leading to a stroke, which is the third leading cause of death in the United States. Several recent investigations have found that plaque structure and composition may represent a more direct biomarker of plaque rupture risk compared with the degree of stenosis. In this study, pulse wave imaging was applied in 111 (n = 11, N = 13 plaques) patients diagnosed with moderate (>50%) to severe (>80%) carotid artery stenosis to investigate the feasibility of characterizing plaque properties based on the pulse wave-induced arterial wall dynamics captured by pulse wave imaging. Five (n = 5 patients, N = 20 measurements) healthy volunteers were also imaged as a control group. Both conventional and high-frame-rate plane wave radiofrequency imaging sequences were used to generate piecewise maps of the pulse wave velocity (PWV) at a single depth along stenotic carotid segments, as well as intra-plaque PWV mapping at multiple depths. Intra-plaque cumulative displacement and strain maps were also calculated for each plaque region. The Bramwell(cid:3)Hill equation was used to estimate the compliance of the plaque regions based on the PWV and diameter. Qualitatively, wave convergence, elevated PWV and decreased cumulative displacement around and/or within regions of atherosclerotic plaque were observed and may serve as biomarkers for plaque characterization. Intra-plaque mapping revealed the potential to capture wave re?ections between calci?ed inclusions and differentiate stable (i.e., calci?ed) from vulnerable (i.e., lipid) plaque components based on the intra-plaque PWV and cumulative strain. Quantitatively, one-way analysis of variance indicated that the pulse wave-induced cumulative strain was signi?cantly lower (p < 0.01) in the moderately and severely calci?ed plaques compared with the normal controls. As expected, compliance was also signi?cantly lower in the severely calci?ed plaques regions compared with the normal controls (p < 0.01). The results from this pilot study indicated the potential of pulse wave imaging coupled with strain imaging to differentiate plaques of varying stiffness, location and composition. Such ?ndings may serve as valuable information to compensate for the limitations of currently used methods for the assessment of stroke risk. (E-mail: ek2191@columbia.edu) ? 2018 World Federation for Ultrasound in Medicine & Biology. All rights reserved.
关键词： Arterial wall elasticity maps,Arterial wall motion,Atherosclerosis,Pulse wave velocity,Pulse wave imaging,High-frame-rate ultrasound,Calci?ed plaque,Arterial compliance
更新于2025-09-23 15:21:01
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Evaluation of plaque characteristics in coronary artery patients with impaired glucose tolerance through optical coherence tomography
摘要： OBJECTIVE: With the adoption of optical coherence tomography (OCT), this study targets the impacts on plaque characteristics brought about by impaired glucose tolerance (IGT) in patients with coronary artery disease. METHODS: For this study, 150 patients with coronary artery disease were recruited. Regarding glycosylated hemoglobin (HbAlc), the patients were sectioned into normal glucose tolerance (NGT), impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and diabetes mellitus (DM) groups. Coronary angiography (CAG) and OCT were conducted for 150 patients. RESULTS: There were 186 plaques discovered in 150 patients (37, 40, 44, and 65 in the NGT, IFG, IGT, and DM groups, respectively). Compared to the NGT group, the lipid core size, which is presented as the average angle of the lipid arc, was markedly larger in the IFG,IGT and DM groups ( 135.7 ± 32.7 ê, 161.2 ± 55.7 ê, 162.5 ± 55.8 ê, and 170.2 ± 59.7 ê, respectively, all P values< 0.05). Meanwhile, the fibrous cap over the lipid core in the NGT group was remarkably thicker than that in the IFG, IGT, and DM groups (115.7 ± 47.7 μm vs. 77.7 ± 23.5 μm, 75.1 ± 23.2 μm, 71.2 ± 22.1 μm, all P values<0.05). CONCLUSION: Coronary plaques in coronary artery patients with NDT are more stable than in those with IGT and DM.
关键词： Diabetes Mellitus,Tomography, Optical Coherence,Coronary Artery Disease,Atherosclerosis,Coronary Disease
更新于2025-09-23 15:21:01