Differentiation of Vulnerable Carotid Plaques by Analysis of Calcium Content and Spectral Curve Slope using Gemstone Spectral Imaging

Abstract Growing evidence indicates that vulnerable carotid plaque rupture is an important cause of stroke. However, fewer studies have been conducted to investigate the role of a novel gemstone spectral imaging (GSI) in assessment of vulnerable carotid plaque. In this study, we analyzed GSI data including calcium content of carotid atherosclerotic plaque and spectral curve slope, as well as serum high-sensitivity C-reactive protein (Hs-CRP), monocyte chemotactic protein-1 (MCP-1) levels in patients with carotid atherosclerotic plaque using the GSI-computed tomographic angiography (CTA) and immunoturbidimetry. The patients with unstable plaques demonstrated a significantly lower calcium content and higher spectral curve slope than the stable plaques group. In addition, the patients with unstable plaque showed an increase in Hs-CRP levels and MCP-1 levels compared with the stable plaque and normal controls (NC) group. The alternation in GSI calcium content and spectral curve slope reflects a close link between calcification and plaque instability, while derangement of Hs-CRP and MCP-1 is involved in the formation or development of vulnerable plaques. Taken together, our results strongly support the feasibility of using these serological and newly discovered imaging parameters as multiple potential biomarkers relevant to plaque vulnerability or stroke progression.