Carotid plaque dynamic contrast-enhanced magnetic resonance imaging normalised signal intensity reproducibly differs between plaque and vessel wall

ABSTRACT Background Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) enables non-invasive characterization of carotid atherosclerotic plaque. Purpose To evaluate the performance and reproducibility of a simplified DCE-MRI quantification method for carotid plaque assessment. Methods T1-weighted black-blood DCE-MRI of the carotid arteries at 3T was performed at baseline and after six months in patients with mild-to-moderate atherosclerotic lesions in a pilot placebo-controlled randomized trial evaluating the effects of low-dose (0.5mg daily) colchicine therapy on carotid plaque volume. DCE-MRI signal intensity was measured in manually drawn regions of interest in the plaque core, remote non-atherosclerotic vessel wall, and skeletal muscle. Peak signal intensities were normalized to skeletal muscle signal in the same slice. Results In patients (n=28, median [interquartile range] age 72 [64–74] years, 36% female, n=13/15 colchicine/placebo), normalized peak signal intensity was higher in the plaque core than in the remote vessel wall at both baseline (3.5 [2.3–4.1] vs 2.1 [1.7–2.5], p0.35 for either region). Conclusions Normalised peak signal intensity on DCE-MRI was consistently higher in the carotid plaque core than in the remote vessel wall, showed excellent reproducibility in both regions over six months, and was not altered by colchicine treatment. This simplified, muscle-normalised approach may facilitate future studies exploring DCE-MRI measures potentially related to plaque vulnerability.