Quantitative CT Imaging of Carotid Arteries

  • Max J. van Gils
  • K. Hameeteman
  • M. van Straten
  • W. J. Niessen
  • Aad van der Lugt


Noninvasive imaging techniques provide a window to atherosclerotic disease in vivo. Multidetector CT angiography represents a potential clinical tool to monitor carotid atherosclerosis, since it is a robust, readily available, and fast technique and it enables (semi)automated quantification of luminal measures as well as of plaque burden and plaque composition. This chapter reviews the state-of-the-art CTA technique used to evaluate carotid artery stenosis and atherosclerotic plaque.


Compute Tomography Angiography Digital Subtraction Angiography Hounsfield Unit Carotid Stenosis Plaque Volume 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Roger VL, Go AS, Lloyd-Jones DM, Adams RJ, Berry JD, Brown TM, Carnethon MR, Dai S, de Simone G, Ford ES, Fox CS, Fullerton HJ, Gillespie C, Greenlund KJ, Hailpern SM, Heit JA, Ho PM, Howard VJ, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Makuc DM, Marcus GM, Marelli A, Matchar DB, McDermott MM, Meigs JB, Moy CS, Mozaffarian D, Mussolino ME, Nichol G, Paynter NP, Rosamond WD, Sorlie PD, Stafford RS, Turan TN, Turner MB, Wong ND, Wylie-Rosett J, American Heart Association Statistics Committee and Stroke Statistics Subcommittee (2011) Heart disease and stroke statistics – 2011 update: a report from the American Heart Association. Circulation 123(4):e18–e209. doi: 10.1161/CIR.0b013e3182009701, CIR.0b013e3182009701 [pii]PubMedCrossRefGoogle Scholar
  2. 2.
    Warlow C, Sudlow C, Dennis M, Wardlaw J, Sandercock P (2003) Stroke. Lancet 362(9391):1211–1224. doi: 10.1016/S0140-6736(03)14544-8, S0140-6736(03)14544-8 [pii]PubMedCrossRefGoogle Scholar
  3. 3.
    (1991) Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators. N Engl J Med 325(7):445–453. doi: 10.1056/NEJM199108153250701
  4. 4.
    (1998) Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST). Lancet 351(9113):1379–1387. doi:S0140673697092921 [pii]Google Scholar
  5. 5.
    Rothwell PM, Eliasziw M, Gutnikov SA, Fox AJ, Taylor DW, Mayberg MR, Warlow CP, Barnett HJ, Carotid Endarterectomy Trialists C (2003) Analysis of pooled data from the randomised controlled trials of endarterectomy for symptomatic carotid stenosis. Lancet 361(9352):107–116, doi:S0140673603122283 [pii]PubMedCrossRefGoogle Scholar
  6. 6.
    (1995) Endarterectomy for asymptomatic carotid artery stenosis. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. JAMA 273(18):1421–1428Google Scholar
  7. 7.
    Halliday A, Mansfield A, Marro J, Peto C, Peto R, Potter J, Thomas D, Group MRCACSTC (2004) Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: randomised controlled trial. Lancet 363(9420):1491–1502. doi: 10.1016/S0140-6736(04)16146-1, S0140673604161461 [pii]PubMedCrossRefGoogle Scholar
  8. 8.
    Hobson RW 2nd, Weiss DG, Fields WS, Goldstone J, Moore WS, Towne JB, Wright CB (1993) Efficacy of carotid endarterectomy for asymptomatic carotid stenosis. The Veterans Affairs Cooperative Study Group. N Engl J Med 328(4):221–227. doi: 10.1056/NEJM199301283280401 PubMedCrossRefGoogle Scholar
  9. 9.
    Naghavi M, Libby P, Falk E, Casscells SW, Litovsky S, Rumberger J, Badimon JJ, Stefanadis C, Moreno P, Pasterkamp G, Fayad Z, Stone PH, Waxman S, Raggi P, Madjid M, Zarrabi A, Burke A, Yuan C, Fitzgerald PJ, Siscovick DS, de Korte CL, Aikawa M, Juhani Airaksinen KE, Assmann G, Becker CR, Chesebro JH, Farb A, Galis ZS, Jackson C, Jang IK, Koenig W, Lodder RA, March K, Demirovic J, Navab M, Priori SG, Rekhter MD, Bahr R, Grundy SM, Mehran R, Colombo A, Boerwinkle E, Ballantyne C, Insull W Jr, Schwartz RS, Vogel R, Serruys PW, Hansson GK, Faxon DP, Kaul S, Drexler H, Greenland P, Muller JE, Virmani R, Ridker PM, Zipes DP, Shah PK, Willerson JT (2003) From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: part I. Circulation 108(14):1664–1672. doi: 10.1161/01.CIR.0000087480.94275.97 , 108/14/1664 [pii]PubMedCrossRefGoogle Scholar
  10. 10.
    Lovett JK, Gallagher PJ, Hands LJ, Walton J, Rothwell PM (2004) Histological correlates of carotid plaque surface morphology on lumen contrast imaging. Circulation 110(15):2190–2197. doi: 10.1161/01.CIR.0000144307.82502.32, 01.CIR.0000144307.82502.32 [pii]PubMedCrossRefGoogle Scholar
  11. 11.
    Eliasziw M, Streifler JY, Fox AJ, Hachinski VC, Ferguson GG, Barnett HJ (1994) Significance of plaque ulceration in symptomatic patients with high-grade carotid stenosis. North American Symptomatic Carotid Endarterectomy Trial. Stroke 25(2):304–308PubMedCrossRefGoogle Scholar
  12. 12.
    Rothwell PM, Gibson R, Warlow CP (2000) Interrelation between plaque surface morphology and degree of stenosis on carotid angiograms and the risk of ischemic stroke in patients with symptomatic carotid stenosis. On behalf of the European Carotid Surgery Trialists’ Collaborative Group. Stroke 31(3):615–621PubMedCrossRefGoogle Scholar
  13. 13.
    Hankey GJ, Warlow CP, Molyneux AJ (1990) Complications of cerebral angiography for patients with mild carotid territory ischaemia being considered for carotid endarterectomy. J Neurol Neurosurg Psychiatry 53(7):542–548PubMedCrossRefGoogle Scholar
  14. 14.
    Willinsky RA, Taylor SM, TerBrugge K, Farb RI, Tomlinson G, Montanera W (2003) Neurologic complications of cerebral angiography: prospective analysis of 2,899 procedures and review of the literature. Radiology 227(2):522–528. doi: 10.1148/radiol.2272012071, 2272012071 [pii]PubMedCrossRefGoogle Scholar
  15. 15.
    Saba L, Anzidei M, Sanfilippo R, Montisci R, Lucatelli P, Catalano C, Passariello R, Mallarini G (2011) Imaging of the carotid artery. Atherosclerosis 220(2):294–309. doi: 10.1016/j.atherosclerosis.2011.08.048, S0021-9150(11)00852-5 [pii]PubMedCrossRefGoogle Scholar
  16. 16.
    European Society of Radiology (2010) White paper on imaging biomarkers. Insights Imaging 1:42–45. doi: 10.1007/s13244-010-0025-8 CrossRefGoogle Scholar
  17. 17.
    Beitzke D, Wolf F, Edelhauser G, Plank C, Schernthaner R, Weber M, Nolz R, Lammer J, Loewe C (2011) Computed tomography angiography of the carotid arteries at low kV settings: a prospective randomised trial assessing radiation dose and diagnostic confidence. Eur Radiol 21(11):2434–2444. doi: 10.1007/s00330-011-2188-1 PubMedCrossRefGoogle Scholar
  18. 18.
    Cademartiri F, van der Lugt A, Luccichenti G, Pavone P, Krestin GP (2002) Parameters affecting bolus geometry in CTA: a review. J Comput Assist Tomogr 26(4):598–607, doi:00004728-200207000-00022 [pii]PubMedCrossRefGoogle Scholar
  19. 19.
    de Monye C, de Weert TT, Zaalberg W, Cademartiri F, Siepman DA, Dippel DW, van der Lugt A (2006) Optimization of CT angiography of the carotid artery with a 16-MDCT scanner: craniocaudal scan direction reduces contrast material-related perivenous artifacts. AJR Am J Roentgenol 186(6):1737–1745. doi: 10.2214/AJR.05.0143, 186/6/1737 [pii]PubMedCrossRefGoogle Scholar
  20. 20.
    Liu Y, Hopper KD, Mauger DT, Addis KA (2000) CT angiographic measurement of the carotid artery: optimizing visualization by manipulating window and level settings and contrast material attenuation. Radiology 217(2):494–500PubMedGoogle Scholar
  21. 21.
    de Weert TT, Ouhlous M, Zondervan PE, Hendriks JM, Dippel DW, van Sambeek MR, van der Lugt A (2005) In vitro characterization of atherosclerotic carotid plaque with multidetector computed tomography and histopathological correlation. Eur Radiol 15(9):1906–1914. doi: 10.1007/s00330-005-2712-2 PubMedCrossRefGoogle Scholar
  22. 22.
    van Straten M, Venema HW, Streekstra GJ, Majoie CB, den Heeten GJ, Grimbergen CA (2004) Removal of bone in CT angiography of the cervical arteries by piecewise matched mask bone elimination. Med Phys 31(10):2924–2933PubMedCrossRefGoogle Scholar
  23. 23.
    Venema HW, Hulsmans FJ, den Heeten GJ (2001) CT angiography of the circle of Willis and intracranial internal carotid arteries: maximum intensity projection with matched mask bone elimination-feasibility study. Radiology 218(3):893–898PubMedGoogle Scholar
  24. 24.
    Uotani K, Watanabe Y, Higashi M, Nakazawa T, Kono AK, Hori Y, Fukuda T, Kanzaki S, Yamada N, Itoh T, Sugimura K, Naito H (2009) Dual-energy CT head bone and hard plaque removal for quantification of calcified carotid stenosis: utility and comparison with digital subtraction angiography. Eur Radiol 19(8):2060–2065. doi: 10.1007/s00330-009-1358-x PubMedCrossRefGoogle Scholar
  25. 25.
    Elgersma OE, Buijs PC, Wust AF, van der Graaf Y, Eikelboom BC, Mali WP (1999) Maximum internal carotid arterial stenosis: assessment with rotational angiography versus conventional intraarterial digital subtraction angiography. Radiology 213(3):777–783PubMedGoogle Scholar
  26. 26.
    Koelemay MJ, Nederkoorn PJ, Reitsma JB, Majoie CB (2004) Systematic review of computed tomographic angiography for assessment of carotid artery disease. Stroke 35(10):2306–2312. doi: 10.1161/, [pii]PubMedCrossRefGoogle Scholar
  27. 27.
    Hollingworth W, Nathens AB, Kanne JP, Crandall ML, Crummy TA, Hallam DK, Wang MC, Jarvik JG (2003) The diagnostic accuracy of computed tomography angiography for traumatic or atherosclerotic lesions of the carotid and vertebral arteries: a systematic review. Eur J Radiol 48(1):88–102, doi:S0720048X03002006 [pii]PubMedCrossRefGoogle Scholar
  28. 28.
    Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig LM, Lijmer JG, Moher D, Rennie D, de Vet HC, Standards for Reporting of Diagnostic Accuracy (2003) Towards complete and accurate reporting of studies of diagnostic accuracy: the STARD initiative. Clin Radiol 58(8):575–580, doi:S0009926003002587 [pii]PubMedCrossRefGoogle Scholar
  29. 29.
    Wardlaw JM, Chappell FM, Best JJ, Wartolowska K, Berry E, NHS Research and Development Health Technology Assessment Carotid Stenosis Imaging Group (2006) Non-invasive imaging compared with intra-arterial angiography in the diagnosis of symptomatic carotid stenosis: a meta-analysis. Lancet 367(9521): 1503–1512. doi: 10.1016/S0140-6736(06)68650-9, S0140-6736 (06)68650-9 [pii]PubMedCrossRefGoogle Scholar
  30. 30.
    Chappell FM, Wardlaw JM, Young GR, Gillard JH, Roditi GH, Yip B, Pell JP, Rothwell PM, Brown MM, Gough MJ, Randall MS (2009) Carotid artery stenosis: accuracy of noninvasive tests – individual patient data meta-analysis. Radiology 251(2):493–502. doi: 10.1148/radiol.2512080284, 2512080284 [pii]PubMedCrossRefGoogle Scholar
  31. 31.
    Josephson SA, Bryant SO, Mak HK, Johnston SC, Dillon WP, Smith WS (2004) Evaluation of carotid stenosis using CT angiography in the initial evaluation of stroke and TIA. Neurology 63(3):457–460, doi:63/3/457 [pii]PubMedCrossRefGoogle Scholar
  32. 32.
    Hacklander T, Wegner H, Hoppe S, Danckworth A, Kempkes U, Fischer M, Mertens H, Caldwell JH (2006) Agreement of multislice CT angiography and MR angiography in assessing the degree of carotid artery stenosis in consideration of different methods of postprocessing. J Comput Assist Tomogr 30(3):433–442, doi:00004728-200605000-00014 [pii]PubMedCrossRefGoogle Scholar
  33. 33.
    Howard P, Bartlett ES, Symons SP, Fox AJ, Aviv RI (2010) Measurement of carotid stenosis on computed tomographic angiography: reliability depends on postprocessing technique. Can Assoc Radiol J 61(3):127–132. doi: 10.1016/j.carj.2009.10.013, S0846-5371(09)00220-4 [pii]PubMedCrossRefGoogle Scholar
  34. 34.
    Puchner S, Popovic M, Wolf F, Reiter M, Lammer J, Bucek RA (2009) Multidetector CTA in the quantification of internal carotid artery stenosis: value of different reformation techniques and axial source images compared with selective carotid arteriography. J Endovasc Ther 16(3):336–342. doi: 10.1583/08-2636.1, 08-2636 [pii]PubMedCrossRefGoogle Scholar
  35. 35.
    Kirbas C, Quek F (2004) A review of vessel extraction techniques and algorithms. ACM Comput Surv 36(2):81–121. doi: 10.1145/1031120.1031121 CrossRefGoogle Scholar
  36. 36.
    Lesage D, Angelini ED, Bloch I, Funka-Lea G (2009) A review of 3D vessel lumen segmentation techniques: models, features and extraction schemes. Med Image Anal 13(6):819–845. doi: 10.1016/, S1361-8415(09)00067-X [pii]PubMedCrossRefGoogle Scholar
  37. 37.
    Manniesing R, Schaap M, Rozie S, Hameeteman R, Vukadinovic D, van der Lugt A, Niessen W (2010) Robust CTA lumen segmentation of the atherosclerotic carotid artery bifurcation in a large patient population. Med Image Anal 14(6):759–769. doi: 10.1016/, S1361-8415(10)00046-0 [pii]PubMedCrossRefGoogle Scholar
  38. 38.
    Manniesing R, Viergever MA, Niessen WJ (2007) Vessel axis tracking using topology constrained surface evolution. IEEE Trans Med Imaging 26(3):309–316. doi: 10.1109/TMI.2006.891503 PubMedCrossRefGoogle Scholar
  39. 39.
    Milwer MB, Valencia LF, Hoyos MH, Magnin IE, Orkisz M (2007) Fast-marching contours for the segmentation of vessel lumen in CTA cross-sections. Conf Proc IEEE Eng Med Biol Soc 2007:791–794. doi: 10.1109/IEMBS.2007.4352409 PubMedGoogle Scholar
  40. 40.
    Cuisenaire O, Virmani S, Olszewski M, Ardon R (2008) Fully automated segmentation of carotid and vertebral arteries from contrast enhanced CTA. In: Reinhardt (ed) Med imaging 2008: image processing, SPIE. pp R–R-8. doi: 10.1117/12.770481
  41. 41.
    Hameeteman K, Zuluaga MA, Freiman M, Joskowicz L, Cuisenaire O, Valencia LF, Gulsun MA, Krissian K, Mille J, Wong WC, Orkisz M, Tek H, Hoyos MH, Benmansour F, Chung AC, Rozie S, van Gils M, van den Borne L, Sosna J, Berman P, Cohen N, Douek PC, Sanchez I, Aissat M, Schaap M, Metz CT, Krestin GP, van der Lugt A, Niessen WJ, van Walsum T (2011) Evaluation framework for carotid bifurcation lumen segmentation and stenosis grading. Med Image Anal 15(4):477–488. doi: 10.1016/, S1361-8415(11)00026-0 [pii]PubMedCrossRefGoogle Scholar
  42. 42.
    Scherl H, Hornegger J, Prummer M, Lell M (2007) Semi-automatic level-set based segmentation and stenosis quantification of the internal carotid artery in 3D CTA data sets. Med Image Anal 11(1):21–34. doi: 10.1016/, S1361-8415(06)00076-4 [pii]PubMedCrossRefGoogle Scholar
  43. 43.
    Wintermark M, Glastonbury C, Tong E, Lau BC, Schaeffer S, Chien JD, Haar PJ, Saloner D (2008) Semi-automated computer assessment of the degree of carotid artery stenosis compares favorably to visual evaluation. J Neurol Sci 269(1–2):74–79. doi: 10.1016/j.jns.2007.12.023, S0022-510X(07)00816-7 [pii]PubMedCrossRefGoogle Scholar
  44. 44.
    Berg M, Zhang Z, Ikonen A, Manninen H, Vanninen R (2005) Carotid stenosis assessment with CT angiography using advanced vessel analysis software. Int Congr Ser 1281:322–327CrossRefGoogle Scholar
  45. 45.
    Zhang Z, Berg M, Ikonen A, Kononen M, Kalviainen R, Manninen H, Vanninen R (2005) Carotid stenosis degree in CT angiography: assessment based on luminal area versus luminal diameter measurements. Eur Radiol 15(11):2359–2365. doi: 10.1007/s00330-005-2801-2 PubMedCrossRefGoogle Scholar
  46. 46.
    Groen HC, Gijsen FJ, van der Lugt A, Ferguson MS, Hatsukami TS, van der Steen AF, Yuan C, Wentzel JJ (2007) Plaque rupture in the carotid artery is localized at the high shear stress region: a case report. Stroke 38(8):2379–2381. doi: 10.1161/STROKEAHA.107.484766, STROKEAHA.107.484766 [pii]PubMedCrossRefGoogle Scholar
  47. 47.
    Lee SW, Antiga L, Spence JD, Steinman DA (2008) Geometry of the carotid bifurcation predicts its exposure to disturbed flow. Stroke 39(8):2341–2347. doi: 10.1161/STROKEAHA.107.510644, STROKEAHA.107.510644 [pii]PubMedCrossRefGoogle Scholar
  48. 48.
    Cademartiri F, Mollet NR, Runza G, Bruining N, Hamers R, Somers P, Knaapen M, Verheye S, Midiri M, Krestin GP, de Feyter PJ (2005) Influence of intracoronary attenuation on coronary plaque measurements using multislice computed tomography: observations in an ex vivo model of coronary computed tomography angiography. Eur Radiol 15(7):1426–1431. doi: 10.1007/s00330-005-2697-x PubMedCrossRefGoogle Scholar
  49. 49.
    Romero JM, Babiarz LS, Forero NP, Murphy EK, Schaefer PW, Gonzalez RG, Lev MH (2009) Arterial wall enhancement overlying carotid plaque on CT angiography correlates with symptoms in patients with high grade stenosis. Stroke 40(5):1894–1896. doi: 10.1161/STROKEAHA.108.529008, STROKEAHA.108.529008 [pii]PubMedCrossRefGoogle Scholar
  50. 50.
    Saba L, Mallarini G (2011) Carotid plaque enhancement and symptom correlations: an evaluation by using multidetector row CT angiography. AJNR Am J Neuroradiol 32(10):1919–1925. doi: 10.3174/ajnr.A2605, ajnr.A2605 [pii]PubMedCrossRefGoogle Scholar
  51. 51.
    Streifler JY, Eliasziw M, Fox AJ, Benavente OR, Hachinski VC, Ferguson GG, Barnett HJ (1994) Angiographic detection of carotid plaque ulceration. Comparison with surgical observations in a multicenter study. North American Symptomatic Carotid Endarterectomy Trial. Stroke 25(6):1130–1132PubMedCrossRefGoogle Scholar
  52. 52.
    Randoux B, Marro B, Koskas F, Duyme M, Sahel M, Zouaoui A, Marsault C (2001) Carotid artery stenosis: prospective comparison of CT, three-dimensional gadolinium-enhanced MR, and conventional angiography. Radiology 220(1):179–185PubMedGoogle Scholar
  53. 53.
    Walker LJ, Ismail A, McMeekin W, Lambert D, Mendelow AD, Birchall D (2002) Computed tomography angiography for the evaluation of carotid atherosclerotic plaque: correlation with histopathology of endarterectomy specimens. Stroke 33(4):977–981PubMedCrossRefGoogle Scholar
  54. 54.
    Saba L, Caddeo G, Sanfilippo R, Montisci R, Mallarini G (2007) Efficacy and sensitivity of axial scans and different reconstruction methods in the study of the ulcerated carotid plaque using multidetector-row CT angiography: comparison with surgical results. AJNR Am J Neuroradiol 28(4):716–723, doi:28/4/716 [pii]PubMedGoogle Scholar
  55. 55.
    de Weert TT, Cretier S, Groen HC, Homburg P, Cakir H, Wentzel JJ, Dippel DW, van der Lugt A (2009) Atherosclerotic plaque surface morphology in the carotid bifurcation assessed with multidetector computed tomography angiography. Stroke 40(4):1334–1340. doi: 10.1161/STROKEAHA.108.538439, STROKEAHA.108.538439 [pii]PubMedCrossRefGoogle Scholar
  56. 56.
    Wintermark M, Jawadi SS, Rapp JH, Tihan T, Tong E, Glidden DV, Abedin S, Schaeffer S, Acevedo-Bolton G, Boudignon B, Orwoll B, Pan X, Saloner D (2008) High-resolution CT imaging of carotid artery atherosclerotic plaques. AJNR Am J Neuroradiol 29(5):875–882. doi: 10.3174/ajnr.A0950, ajnr.A0950 [pii]PubMedCrossRefGoogle Scholar
  57. 57.
    Estes JM, Quist WC, Lo Gerfo FW, Costello P (1998) Noninvasive characterization of plaque morphology using helical computed tomography. J Cardiovasc Surg (Torino) 39(5):527–534Google Scholar
  58. 58.
    Oliver TB, Lammie GA, Wright AR, Wardlaw J, Patel SG, Peek R, Ruckley CV, Collie DA (1999) Atherosclerotic plaque at the carotid bifurcation: CT angiographic appearance with histopathologic correlation. AJNR Am J Neuroradiol 20(5):897–901PubMedGoogle Scholar
  59. 59.
    de Weert TT, Ouhlous M, Meijering E, Zondervan PE, Hendriks JM, van Sambeek MR, Dippel DW, van der Lugt A (2006) In vivo characterization and quantification of atherosclerotic carotid plaque components with multidetector computed tomography and histopathological correlation. Arterioscler Thromb Vasc Biol 26(10):2366–2372. doi: 10.1161/01.ATV.0000240518.90124.57, 01.ATV.0000240518.90124.57 [pii]PubMedCrossRefGoogle Scholar
  60. 60.
    Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M Jr, Detrano R (1990) Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 15(4):827–832, doi:0735-1097(90)90282-T [pii]PubMedCrossRefGoogle Scholar
  61. 61.
    Kwee RM (2010) Systematic review on the association between calcification in carotid plaques and clinical ischemic symptoms. J Vasc Surg 51(4):1015–1025. doi: 10.1016/j.jvs.2009.08.072, S0741-5214(09)01788-1 [pii]PubMedCrossRefGoogle Scholar
  62. 62.
    de Weert TT, de Monye C, Meijering E, Booij R, Niessen WJ, Dippel DW, van der Lugt A (2008) Assessment of atherosclerotic carotid plaque volume with multidetector computed tomography angiography. Int J Cardiovasc Imaging 24(7):751–759. doi: 10.1007/s10554-008-9309-1 PubMedCrossRefGoogle Scholar
  63. 63.
    Vukadinovic D, van Walsum T, Manniesing R, Rozie S, Hameeteman R, de Weert TT, van der Lugt A, Niessen WJ (2010) Segmentation of the outer vessel wall of the common carotid artery in CTA. IEEE Trans Med Imaging 29(1):65–76. doi: 10.1109/TMI.2009.2025702 PubMedCrossRefGoogle Scholar
  64. 64.
    Vukadinovic D, Rozie S, van Gils M, van Walsum T, Manniesing R, van der Lugt A, Niessen WJ (2011) Automated versus manual segmentation of atherosclerotic carotid plaque volume and components in CTA: associations with cardiovascular risk factors. Int J Cardiovasc Imaging 28(4):877–887. doi: 10.1007/s10554-011-9890-6 PubMedCrossRefGoogle Scholar
  65. 65.
    Rozie S, de Weert TT, de Monye C, Homburg PJ, Tanghe HL, Dippel DW, van der Lugt A (2009) Atherosclerotic plaque volume and composition in symptomatic carotid arteries assessed with multidetector CT angiography; relationship with severity of stenosis and cardiovascular risk factors. Eur Radiol 19(9):2294–2301. doi: 10.1007/s00330-009-1394-6 PubMedCrossRefGoogle Scholar
  66. 66.
    Homburg PJ, Rozie S, van Gils MJ, van den Bouwhuijsen QJ, Niessen WJ, Dippel DW, van der Lugt A (2011) Association between carotid artery plaque ulceration and plaque composition evaluated with multidetector CT angiography. Stroke 42(2):367–372. doi: 10.1161/STROKEAHA.110.597369, STROKEAHA.110.597369 [pii]PubMedCrossRefGoogle Scholar
  67. 67.
    Wintermark M, Arora S, Tong E, Vittinghoff E, Lau BC, Chien JD, Dillon WP, Saloner D (2008) Carotid plaque computed tomography imaging in stroke and nonstroke patients. Ann Neurol 64(2):149–157. doi: 10.1002/ana.21424 PubMedCrossRefGoogle Scholar
  68. 68.
    Nandalur KR, Hardie AD, Raghavan P, Schipper MJ, Baskurt E, Kramer CM (2007) Composition of the stable carotid plaque: insights from a multidetector computed tomography study of plaque volume. Stroke 38(3):935–940. doi: 10.1161/01.STR.0000257995.74834.92, 01.STR.0000257995. 74834.92 [pii]PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2014

Authors and Affiliations

  • Max J. van Gils
    • 1
  • K. Hameeteman
    • 2
    • 3
  • M. van Straten
    • 1
  • W. J. Niessen
    • 2
    • 3
    • 4
  • Aad van der Lugt
    • 1
  1. 1.Department of Radiology, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
  2. 2.Biomedical Imaging Group Rotterdam, Department of Radiology, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
  3. 3.Biomedical Imaging Group Rotterdam, Department of Medical Informatics, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
  4. 4.Imaging Science and TechnologyDelft University of TechnologyDelftThe Netherlands

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