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Clinical feasibility of carotid plaque inflammation imaging by microwave radiometry

Session Poster Session 7

Speaker Konstantinos Toutouzas

Event : ESC Congress 2013

  • Topic : interventional cardiology and cardiovascular surgery
  • Sub-topic : Interventional Cardiology
  • Session type : Poster Session

Authors : M Drakopoulou (Athens,GR), K Toutouzas (Athens,GR), G Benetos (Athens,GR), E Tolis (Athens,GR), E Tsiamis (Athens,GR), H Grassos (Athens,GR), G Agrogiannis (Athens,GR), E Siores (Bolton,GB), E Patsouris (Athens,GR), CH Stefanadis (Athens,GR)

M. Drakopoulou1 , K. Toutouzas1 , G. Benetos1 , E. Tolis1 , E. Tsiamis1 , H. Grassos1 , G. Agrogiannis2 , E. Siores3 , E. Patsouris2 , C.H. Stefanadis1 , 1Hippokration Hospital, University of Athens, 1st Department of Cardiology - Athens - Greece , 2University of Athens Medical School, 1st Department of Pathology - Athens - Greece , 3University of Bolton, Centre for Material Research and Innovation - Bolton - United Kingdom ,

European Heart Journal ( 2013 ) 34 ( Abstract Supplement ), 999

Purpose: Carotid plaques exhibit thermal heterogeneity mainly attributed to increased density of inflammatory cells. Microwave radiometry (MR) is a new method based on the ability to detect noninvasively, with high accuracy, relative changes of temperature in human tissues, reflecting inflammation. We sought to determine whether carotid plaque thermal heterogeneity 1) can be measured with MR non-invasively and 2) is associated with inflammation assessed by histology.

Methods: Thirty-four consecutive patients with either symptomatic or asymptomatic single high-degree carotid artery stenosis who were scheduled for carotid endarterectomy were enrolled prospectively in the study. Healthy volunteers were enrolled as a control group. During ultrasound study, plaque texture, plaque surface, and plaque echogenicity were analyzed. Temperature difference (ΔT) was assigned as maximal minus minimum temperature. Association of thermographic with ultrasound and immunohistochemical findings was performed.

Results: ΔT was higher in atherosclerotic carotid arteries compared with the carotid arteries of controls (1.39°C±0.49°C vs. 0.23°C±0.01°C). Fatty plaques had higher ΔT compared with mixed and calcified (p<0.01) plaques. Plaques with ulcerated surface had higher ΔT compared with plaques with irregular and regular surface (p<0.01). Heterogeneous plaques had higher ΔT compared with homogenous (p<0.01). ΔT was higher in specimens with maximal expression of inflammatory cells compared with specimens with an absence of or focal or circumscribed presence of inflammatory cells (1.74±0.40 vs 1.01±0.21°C p< 0.01). Specimens with intense expression of CD3 (≥2) (n=21) had higher ΔT compared with those with lower expression of CD3 (n=13) (1.66±0.43 vs 0.98±0.21°C, p<0.01). Accordingly, specimens with intense expression of CD68 (≥2) (n=21) had higher ΔT compared with those with lower expression of CD68 (n=13) (p< 0.01). Interestingly, in 21% of the plaques without any ultrasound criteria for vulnerability, high temperature was found in accordance with the histology.

Conclusions: Microwave radiometry may provide in vivo non-invasively temperature measurements of carotid plaques, reflecting their inflammatory activation.

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