Kinetic measures for distinguishing vulnerable from stable atherosclerotic plaque with dynamic contrast-enhanced MRI

Carotid atherosclerosis is a primary cause of stroke, which is responsible for a majority of disabilities and deaths worldwide. Plaque inflammation and abundant microvasculature have been identified as important aspects contributing to plaque vulnerability that can be studied non-invasively with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Due to the asymptomatic nature of vulnerable plaque, there is an unmet clinical need to identify and characterize these lesions before they rupture. We presented an automated computerized method based on kinetic measures to distinguish vulnerable from stable atherosclerotic plaques on DCE-MRI. Four classes of kinectic features, including pharmacokinetic, intensity kinetic, histogram kinetic, and textual kinetic features, were extracted for capturing the pathophysiologic changes in various aspects of plaque vascular structure and functionality in atherosclerosis. These features can reflect the local inflammatory processes and microvasculature changes appearing in plaque destabilization. Our method was evaluated on real clinical data and achieved the area under the curve of 0.95 using a combined feature set, suggesting a potential of this method applied to a computer-aided diagnosis system for an early detection of vulnerable plaques.