Imaging endpoints of intracranial atherosclerosis using vessel wall MR imaging: a systematic review
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DIAGNOSTIC NEURORADIOLOGY
Imaging endpoints of intracranial atherosclerosis using vessel wall MR imaging: a systematic review Jae W. Song 1 & Athanasios Pavlou 1 & Morgan P. Burke 1 & Haochang Shou 2 & Kofi-Buaku Atsina 1 Jiayu Xiao 3 & Laurie A. Loevner 1 & David Mankoff 1 & Zhaoyang Fan 3 & Scott E. Kasner 4
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Received: 9 August 2020 / Accepted: 29 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose The vessel wall MR imaging (VWI) literature was systematically reviewed to assess the criteria and measurement methods of VWI-related imaging endpoints for symptomatic intracranial plaque in patients with ischemic events. Methods PubMed, Scopus, Web of Science, EMBASE, and Cochrane databases were searched up to October 2019. Two independent reviewers extracted data from 47 studies. A modified Guideline for Reporting Reliability and Agreement Studies was used to assess completeness of reporting. Results The specific VWI-pulse sequence used to identify plaque was reported in 51% of studies. A VWI-based criterion to define plaque was reported in 38% of studies. A definition for culprit plaque was reported in 40% of studies. Frequently scored qualitative imaging endpoints were plaque quadrant (21%) and enhancement (21%). Frequently measured quantitative imaging endpoints were stenosis (19%), lumen area (15%), and remodeling index (14%). Reproducibility for all endpoints ranged from good to excellent (range: ICCT1 hyperintensity = 0.451 to ICCstenosis = 0.983). However, rater specialty and years of experience varied among studies. Conclusions Investigators are using different criteria to identify and measure VWI-imaging endpoints for culprit intracranial plaque. Early awareness of these differences to address methods of acquisition and measurement will help focus research resources and efforts in technique optimization and measurement reproducibility. Consensual definitions to detect plaque will be important to develop automatic lesion detection tools particularly in the era of radiomics. Keywords Vessel wall MR imaging . Atherosclerosis . Reproducibility, biomarker
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00234-020-02575-w) contains supplementary material, which is available to authorized users. * Jae W. Song [email protected] 1
Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
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Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
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Department of Biomedical Sciences, Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
4
Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
Intracranial atherosclerotic disease is one of the leading causes of ischemic stroke worldwide. Vessel wall MRI (VWI) is increasingly being used to study intracranial arteries as it may be a more sensitive
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