Non-Invasive Theranostic To Predict And Assess Response To Atherosclerotic Drugs

Effective biomarkers are needed for assessing atherosclerotic plaque vulnerability for prognostic and longitudinal use. We report on a preliminary proof of concept using contrast MRI and textural kinetic analysis. Multivariate quantitative descriptors are developed using controlled outcome studies on a specialized model to identify candidate imaging markers that in composite are able to accurately distinguish vulnerable and stable plaque in both cross‐sectional and longitudinal applications. We hypothesize that characteristic patterns of lipid intermixed with extracellular matrix fibers, necrotic tissue, inflammatory cells and intra‐plaque hemorrhage are detectable via the use of steerable, multi‐scale Gabor filters, localized pixel statistics, and second order co‐occurrence textural features. These derived attributes are capable of discriminating functional microvascular networks without requiring resolution beyond that of standard DCE MRI. Neovascularization, presence of extracellular matrix and increased tissue permeability leading to increased distribution volume is evaluated by fitting cubic polynomials to the contrast media uptake signal to provide more effective separation between vulnerable and stable plaque than possible by merely relying on thresholding of time activity curves. Preliminary results demonstrate good discrimination between interventional study arms.