Carotid magnetic resonance imaging for monitoring atherosclerotic plaque progression: a multicenter reproducibility study

  • Jie Sun
  • Xue-Qiao Zhao
  • Niranjan Balu
  • Daniel S. Hippe
  • Thomas S. Hatsukami
  • Daniel A. Isquith
  • Kiyofumi Yamada
  • Moni B. Neradilek
  • Gádor Cantón
  • Yunjing Xue
  • Jerome L. Fleg
  • Patrice Desvigne-Nickens
  • Michael T. Klimas
  • Robert J. Padley
  • Maria T. Vassileva
  • Bradley T. Wyman
  • Chun Yuan
Original Paper


This study sought to determine the multicenter reproducibility of magnetic resonance imaging (MRI) and the compatibility of different scanner platforms in assessing carotid plaque morphology and composition. A standardized multi-contrast MRI protocol was implemented at 16 imaging sites (GE: 8; Philips: 8). Sixty-eight subjects (61 ± 8 years; 52 males) were dispersedly recruited and scanned twice within 2 weeks on the same magnet. Images were reviewed centrally using a streamlined semiautomatic approach. Quantitative volumetric measurements on plaque morphology (lumen, wall, and outer wall) and plaque tissue composition [lipid-rich necrotic core (LRNC), calcification, and fibrous tissue] were obtained. Inter-scan reproducibility was summarized using the within-subject standard deviation, coefficient of variation (CV) and intraclass correlation coefficient (ICC). Good to excellent reproducibility was observed for both morphological (ICC range 0.98–0.99) and compositional (ICC range 0.88–0.96) measurements. Measurement precision was related to the size of structures (CV range 2.5–4.9 % for morphology, 36–44 % for LRNC and calcification). Comparable measurement variability was found between the two platforms on both plaque morphology and tissue composition. In conclusion, good to excellent inter-scan reproducibility of carotid MRI can be achieved in multicenter settings with comparable measurement precision between platforms, which may facilitate future multicenter endeavors that use serial MRI to monitor atherosclerotic plaque progression.


Magnetic resonance imaging Carotid artery Atherosclerosis Reproducibility Multicenter study 



This study was supported by a Grant from the Foundation for the National Institutes of Health Biomarkers Consortium made possible by funds from Merck, Pfizer, and Abbott, and by R01HL088214. Carotid coils were provided by GE Healthcare and Philips Healthcare. This manuscript represents the views of the authors and not necessarily those of the National Institutes of Health or the United States government.

Conflict of interest

Xue-Qiao Zhao reported research grants from Abbvie, Kowa, Merck, and Pfizer. Daniel S. Hippe reported grant support for analysis of unrelated data from GE Healthcare, Philips Healthcare, Society of Interventional Radiology, and RSNA Research and Education Foundation. Thomas S. Hatsukami reported research grants from Philips Healthcare. Michael T. Klimas is an employee of Merck. Robert J. Padley is an employee of Abbvie and reported stocks of Abbvie. Bradley T. Wyman was a former employee of Pfizer and reported stocks of Pfizer. Chun Yuan reported research grants from NIH, VP Diagnostics, Philips Healthcare, and consulting fees from Bristol Myers Squibb Medical Imaging and Philips Healthcare. The remaining authors reported no conflicts of interest.

Supplementary material

10554_2014_532_MOESM1_ESM.doc (1.1 mb)
Supplementary material 1 (DOC 1166 kb)


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Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  • Jie Sun
    • 1
  • Xue-Qiao Zhao
    • 2
  • Niranjan Balu
    • 1
  • Daniel S. Hippe
    • 1
  • Thomas S. Hatsukami
    • 3
  • Daniel A. Isquith
    • 2
  • Kiyofumi Yamada
    • 1
  • Moni B. Neradilek
    • 5
  • Gádor Cantón
    • 4
  • Yunjing Xue
    • 1
  • Jerome L. Fleg
    • 6
  • Patrice Desvigne-Nickens
    • 6
  • Michael T. Klimas
    • 7
  • Robert J. Padley
    • 8
  • Maria T. Vassileva
    • 9
  • Bradley T. Wyman
    • 10
  • Chun Yuan
    • 1
  1. 1.Department of RadiologyUniversity of WashingtonSeattleUSA
  2. 2.Division of Cardiology, Department of MedicineUniversity of WashingtonSeattleUSA
  3. 3.Department of SurgeryUniversity of WashingtonSeattleUSA
  4. 4.Department of Mechanical EngineeringUniversity of WashingtonSeattleUSA
  5. 5.Mountain-Whisper-Light StatisticsSeattleUSA
  6. 6.National Heart, Lung and Blood InstituteNational Institutes of HealthBethesdaUSA
  7. 7.MerckWhitehouse StationUSA
  8. 8.AbbvieNorth ChicagoUSA
  9. 9.Foundation for the National Institutes of HealthBethesdaUSA
  10. 10.PfizerNew LondonUSA

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