Abstract
PurposeTo evaluate the scan-rescan reproducibility of high-resolution magnetic resonance imaging (MRI) of middle cerebral artery (MCA) plaque, and calculate the number of subjects needed for future longitudinal clinical studies.Material and MethodsTwenty two patients with MCA plaque were scanned twice by a T2-weighted fast-spin-echo sequence at 3T. Areas and volumes of MCA lumen, total vessel and plaque were quantified and compared between two repeated scans. Agreement and measurement error was quantified by intraclass correlation coefficient (ICC) and coefficient of variance (CV) as defined by standard deviation (SD) of pair wise difference / mean. Sample size needed to detect 5% to 20% changes in area/volume was calculated using 80% power and 5% significance level.ResultsThere was no significant different between the area and volume measurements of two repeated scans (p>0.05) with good agreement (ICC range 0.97–0.98 for area and 0.99 for volume). Relatively small measurement errors were observed with CVs range 6.1%-11.8% for area quantification and 4.9%-8.0% for volume quantification. Volume measurements tended to have 19.7% to 32.2% smaller CVs compared with area measurements. Sample size calculation showed a group of 47 patients was sufficient to detect 5% to 10% changes in MCA area/volume.ConclusionHigh resolution MRI is feasible for quantifying intracranial plaque area and volume in longitudinal clinical studies with low scan-rescan variability. Volume measurement tends to be more reproducible compared with area measurements.
Highlights
Intracranial large-artery atherosclerotic disease has a large worldwide burden with a high prevalence in Asian, Hispanic and African races (6–56%) [1]
Volume measurements tended to have 19.7% to 32.2% smaller coefficient of variance (CV) compared with area measurements
Sample size calculation showed a group of 47 patients was sufficient to detect 5% to 10% changes in middle cerebral artery (MCA) area/volume
Summary
Intracranial large-artery atherosclerotic disease has a large worldwide burden with a high prevalence in Asian, Hispanic and African races (6–56%) [1]. Two (2D) and three dimensional (3D) high resolution black blood magnetic resonance imaging (hrMRI) has shown to be a promising tool for imaging intracranial vessel wall due to its non-invasiveness and excellent soft tissue contrast [3,4,5,6,7,8,9]. Despite the small size and deep location posing a great challenge in the intracranial plaque imaging, the development of hrMRI techniques provides opportunities in longitudinal clinical trials to understand the disease progression and optimize the treatment strategy
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