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14 pages, 4196 KiB  
Article
Photodynamic Therapy of Atherosclerotic Plaque Monitored by T1 and T2 Relaxation Times of Magnetic Resonance Imaging
by Piotr Wańczura, David Aebisher, Dawid Leksa, Wiktoria Mytych, Klaudia Dynarowicz, Angelika Myśliwiec, Natalia Leksa, Adrian Truszkiewicz and Dorota Bartusik-Aebisher
Int. J. Transl. Med. 2024, 4(3), 505-518; https://doi.org/10.3390/ijtm4030034 - 5 Aug 2024
Viewed by 193
Abstract
Atherosclerosis, marked by plaque accumulation within arteries, results from lipid dysregulation, inflammation, and vascular remodeling. Plaque composition, including lipid-rich cores and fibrous caps, determines stability and vulnerability. Photodynamic therapy (PDT) has emerged as a promising treatment, leveraging photosensitizers to induce localized cytotoxicity upon [...] Read more.
Atherosclerosis, marked by plaque accumulation within arteries, results from lipid dysregulation, inflammation, and vascular remodeling. Plaque composition, including lipid-rich cores and fibrous caps, determines stability and vulnerability. Photodynamic therapy (PDT) has emerged as a promising treatment, leveraging photosensitizers to induce localized cytotoxicity upon light activation. PDT targets plaque components selectively, reducing burden and inflammation. Challenges remain in optimizing PDT parameters and translating preclinical success to clinical efficacy. Nonetheless, PDT offers a minimally invasive strategy for atherosclerosis management, promising personalized interventions for cardiovascular health. The objective of the current study was to present the findings from quantitative non-contrast MRI of atherosclerosis post-PDT by assessing relaxation times. The study aimed to utilize and optimize a 1.5T MRI system. Clinical scanners were used for MRI examinations. The research involved analyzing T1 and T2 relaxation times. Following treatment of the samples with Rose Bengal and exposure to pure oxygen, PDT irradiation was administered. The results indicated that the therapy impacted the crus, evidenced by a significant decrease in relaxation times in the MRI data. Full article
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<p>View of the retrieved vessel after defrosting.</p>
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<p>Samples with Rose Bengal disodium salt at concentrations of 0.01 mM (No. 1), 0.02 mM (No. 2), 0.03 mM (No. 3), 0.04 mM (No. 4), and 0.05 mM (No. 5).</p>
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<p>Pre and post samples irradiated at 532 nm for 15 min. Samples with Rose Bengal disodium salt at concentrations of 0.01 mM (No. 1), 0.02 mM (No. 2), 0.03 mM (No. 3), 0.04 mM (No. 4), and 0.05 mM (No. 5).</p>
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<p>Tesla Optima MR360 MRI used to determine T1 and T2 relaxation times.</p>
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<p>Determined T1 and T2 relaxation times of atherosclerotic samples before PDT. The yellow box is the area of the Voxel.</p>
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<p>Determined T1 and T2 relaxation times of atherosclerotic samples after PDT. The yellow box is the area of the Voxel.</p>
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<p>(<b>a</b>,<b>d</b>) contain the results of mapping the longitudinal relaxation times. They present maps of the distribution of T1 times. The sharp demarcation between the fluid and the examined structures is clearly visible. (<b>b</b>,<b>e</b>) present the distribution of the R<sup>2</sup> coefficient—it is a measure of the fit of the approximating curve describing the measurement data. It is clearly seen that this coefficient is close to “1”. This proves a very good fit. These figures also show a decrease in the R<sup>2</sup> value for regions more distant from the coil plane. This is a characteristic phenomenon because the coil used has the characteristics of a flat-loop coil which produces very good figures in its plane, but when moving away from it, the signal quality decreases and noise increases. This type of coil was chosen due to the geometric characteristics of the tested objects. The aim of the study was to image the structures lying in the plane of the urethra as well as possible. The figures presented in (<b>c</b>,<b>f</b>) are histograms, allowing determination of the quantitative distribution of pixels in the examined figures. The histogram plot is the number of pixels in the image (vertical axis) with a particular brightness value (horizontal axis). The histogram plot is the distribution of the number of pixels according to their intensities, corresponding to the time value that is calculated.</p>
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<p>(<b>a</b>,<b>d</b>) contain the results of mapping the transverse relaxation times. It should be said that in this case the noise is significantly increased. Very short relaxation times resulted in poorer image quality—the system used for research has limitations regarding the parameters that can be set for TE and TR times. This is most noticeable in the parts of the image showing fluids. The regions imaging the structures being examined are mapped with greater accuracy—their times are significantly longer than the T2 of fluid areas. In the context of the decrease in the quality of fitting the curves to the measurement data, the figures for R<sup>2</sup> (<b>b</b>,<b>e</b>) are very telling, where the fluid areas are dark blue and therefore R<sup>2</sup> is close to the value “0”. (<b>c</b>,<b>f</b>) are histograms showing the distribution of the number of pixels in the examined region. The histogram plot is the number of pixels in the image (vertical axis) with a particular brightness value (horizontal axis). The histogram plot is the distribution of the number of pixels according to their intensities, corresponding to the time value that is calculated.</p>
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14 pages, 1165 KiB  
Article
Elucidating the Relationship between Neutrophil–Lymphocyte Ratio and Plaque Composition in Patients with Drug-Eluting Stent Restenosis by Virtual Histology-Intravascular Ultrasound
by Ming Yu, Yuxing Wang, Song Yang, Jiajie Mei, Zhenzhu Liu, Lijiao Zhang, Wenli Xie, Zhaohong Geng, Baole Liu, Hongyan Wang, Peng Qu and Nan Niu
J. Cardiovasc. Dev. Dis. 2024, 11(7), 211; https://doi.org/10.3390/jcdd11070211 - 4 Jul 2024
Viewed by 501
Abstract
(1) Background: In-stent Restenosis (ISR) is a major factor influencing the prognosis and revascularization of target lesions. The plaque composition is unclear; therefore, it is critical to investigate ISR composition to identify clinical intervention markers. (2) Methods: This study was conducted on 36 [...] Read more.
(1) Background: In-stent Restenosis (ISR) is a major factor influencing the prognosis and revascularization of target lesions. The plaque composition is unclear; therefore, it is critical to investigate ISR composition to identify clinical intervention markers. (2) Methods: This study was conducted on 36 patients with drug-eluting stent restenosis. The patients were classified into a Low Neutrophil–Lymphocyte Ratio (L-NLR) and High Neutrophil–Lymphocyte Ratio (H-NLR) according to the median NLR level of 36 patients. Discrepancies in the current information such as baseline data, biochemical examination, cardiac ultrasound data, etc., were examined to identify the underlying risk factors, and a multifactorial linear regression analysis of plaque properties was conducted. (3) Results: NLR = 2.64 was utilized to classify 18 patients into the L-NLR group and 18 patients into the H-NLR group. There were statistically significant differences in age, a pre-percutaneous coronary intervention (PCI) SYNTAX II score, a C-reactive protein (CRP), interleukin (IL)-6, plaque loading, a fibro-lipid tissue area, calcified nubs, and virtual histology-thin fibrous cap atherosclerotic (VH-TCFA). The significant impacts of variations in age, neutrophil–lymphocyte ratio (NLR) levels, and IL-6 levels on the plaque stress and percentage of the fibro-lipid tissue in virtual histology-intravascular ultrasound (VH-IVUS) were identified through multifactorial linear regression. (4) Conclusions: The high NLR group demonstrated increased myocardial injury severity, consistent with higher SYNTAX II scores, a higher plaque burden, and higher proportions of vulnerable components. NLR proved to be a risk factor for both the plaque load and the proportion of the fibro-lipid tissue in ISR. Full article
(This article belongs to the Section Cardiovascular Clinical Research)
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<p>Coronary angiography stent and stenosis location. (<b>A</b>) Stent position, (<b>B</b>) in-stent restenosis position.</p>
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<p>A concise overview of the standard VH-IVUS observations. (<b>A</b>) Grayscale image of in-stent restenosis, (<b>B</b>) composition of plaques under VH-IVUS, (<b>C</b>) calcified nodules, and (<b>D</b>) VH-TCFA. The fibrous tissue was indicated by the color green, the fibro-lipid tissue by yellow–green, the calcified tissue by white, and the necrotic tissue components by red.</p>
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16 pages, 5926 KiB  
Article
Genomic Features and Phylogenetic Analysis of Antimicrobial-Resistant Salmonella Mbandaka ST413 Strains
by Valdinete P. Benevides, Mauro M. S. Saraiva, Camila F. Nascimento, Enrique J. Delgado-Suárez, Celso J. B. Oliveira, Saura R. Silva, Vitor F. O. Miranda, Henrik Christensen, John E. Olsen and Angelo Berchieri Junior
Microorganisms 2024, 12(2), 312; https://doi.org/10.3390/microorganisms12020312 - 1 Feb 2024
Viewed by 1437
Abstract
In recent years, Salmonella enterica subsp. enterica serovar Mbandaka (S. Mbandaka) has been increasingly isolated from laying hens and shell eggs around the world. Moreover, this serovar has been identified as the causative agent of several salmonellosis outbreaks in humans. Surprisingly, little [...] Read more.
In recent years, Salmonella enterica subsp. enterica serovar Mbandaka (S. Mbandaka) has been increasingly isolated from laying hens and shell eggs around the world. Moreover, this serovar has been identified as the causative agent of several salmonellosis outbreaks in humans. Surprisingly, little is known about the characteristics of this emerging serovar, and therefore, we investigated antimicrobial resistance, virulence, and prophage genes of six selected Brazilian strains of Salmonella Mbandaka using Whole Genome Sequencing (WGS). Multi-locus sequence typing revealed that the tested strains belong to Sequence Type 413 (ST413), which has been linked to recent multi-country salmonellosis outbreaks in Europe. A total of nine resistance genes were detected, and the most frequent ones were aac(6′)-Iaa, sul1, qacE, blaOXA-129, tet(B), and aadA1. A point mutation in ParC at the 57th position (threonine → serine) associated with quinolone resistance was present in all investigated genomes. A 112,960 bp IncHI2A plasmid was mapped in 4/6 strains. This plasmid harboured tetracycline (tetACDR) and mercury (mer) resistance genes, genes contributing to conjugative transfer, and genes involved in plasmid maintenance. Most strains (four/six) carried Salmonella genomic island 1 (SGI1). All S. Mbandaka genomes carried seven pathogenicity islands (SPIs) involved in intracellular survival and virulence: SPIs 1-5, 9, and C63PI. The virulence genes csgC, fimY, tcfA, sscA, (two/six), and ssaS (one/six) were absent in some of the genomes; conversely, fimA, prgH, and mgtC were present in all of them. Five Salmonella bacteriophage sequences (with homology to Escherichia phage phiV10, Enterobacteria phage Fels-2, Enterobacteria phage HK542, Enterobacteria phage ST64T, Salmonella phage SW9) were identified, with protein counts between 31 and 54, genome lengths of 24.7 bp and 47.7 bp, and average GC content of 51.25%. In the phylogenetic analysis, the genomes of strains isolated from poultry in Brazil clustered into well-supported clades with a heterogeneous distribution, primarily associated with strains isolated from humans and food. The phylogenetic relationship of Brazilian S. Mbandaka suggests the presence of strains with high epidemiological significance and the potential to be linked to foodborne outbreaks. Overall, our results show that isolated strains of S. Mbandaka are multidrug-resistant and encode a rather conserved virulence machinery, which is an epidemiological hallmark of Salmonella strains that have successfully disseminated both regionally and globally. Full article
(This article belongs to the Special Issue Research on Foodborne Pathogens and Disease)
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Figure 1
<p>The predicted structure of the 112,960 bp p109518 plasmid from <span class="html-italic">S.</span> Mbandaka (isolate 1095/18) shows backbone and accessory module regions. Genes with a predicted function are denoted by green arrows, hypothetical proteins in yellow, and ORFs in orange. The innermost blue circle presents a GC content of 44.3%.</p>
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<p>Linear BLAST atlas of SGI1 in <span class="html-italic">S.</span> Mbandaka strains 1158/18 (1), 1096/18 (2), 1095/18 (3), and 1092/18 (4). The backbone is represented in grey, the reference sequence (AF261825.2) is represented in a light shade of green, GC content is depicted in black, and GC skew is displayed in purple. A: <span class="html-italic">thdf</span> (product: tRNA-5-carboxymethylaminomethyl-2-thiouridine (34) synthesis protein MnmE), B: <span class="html-italic">intI1</span> (product: integron integrase Inti1), C: <span class="html-italic">aadA2</span> (product: aminoglycoside 3″-nucleotidyltransferase), D: <span class="html-italic">qacEdelta1</span> (product: small multidrug resistance (SMR) efflux transporter =&gt; QacE delta 1, quaternary ammonium compounds), E: <span class="html-italic">sul1delta</span> (product: dihydropteroate synthase type-2—sulphonamide resistance protein), F: <span class="html-italic">sul1</span> (product: dihydropteroate synthase type-2—sulphonamide resistance protein), G: product: similar to puromycin N-acetyltransferase, H: product: hypothetical protein, I: <span class="html-italic">tnpA</span> (product: transposase), J: <span class="html-italic">int2</span> (product: phage integrase) K: <span class="html-italic">yidY</span> (product: multidrug efflux pump MdtL (of MFS type)). The figure was built using the Blast Atlas tool (Gview server).</p>
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<p>BLAST ring image of the SPIs detected in six <span class="html-italic">S.</span> Mbandaka isolates from laying hens and quail in São Paulo State, Brazil. Colour intensities represent the percentage of identity (&gt;90%) with the reference strain <span class="html-italic">Salmonella</span> Typhimurium LT2, while blank areas indicate no identity with the reference. The figure is shown in order from inside to outside, starting from the isolates in the right column.</p>
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<p>Comparative genomic analysis of SPIs 2 and 3. (<b>A</b>) Alignment of the SPI 2 locus and (<b>B</b>) alignment of the SPI 3 locus in <span class="html-italic">Salmonella enterica</span> serovar Typhimurium LT2 to six <span class="html-italic">S.</span> Mbandaka sequences (1092/18, 1095/18, 1096/18, 1097/18, 1124/18, and 1158/18).</p>
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<p>Maximum Likelihood phylogenetic tree of 481 ST413 <span class="html-italic">S.</span> Mbandaka strains recovered from poultry. <span class="html-italic">Escherichia coli</span> (U00096.2), <span class="html-italic">Shigella flexneri</span> (AE014073.1), and <span class="html-italic">Salmonella</span> Typhimurium LT2 (AE006468.2) were used as outgroups and to root the tree. The clade support is indicated above or next to each branch as bootstrap values, as calculated from 1000 pseudoreplicates. The colours in the inner ring of the tree represent the location of isolation and the colours in the outer ring indicate the source of isolation (see legend). The coloured branches represent the division of clades: clade 1 (light pink branch), clade 2 (green branch), clade 3 (purple branch), clade 4 (yellow branch), clade 5 (red branch), and clade 6 (blue branch).</p>
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14 pages, 2267 KiB  
Article
Combined Effects of Ambient PM2.5 and Cold Exposure on the Development of Metabolic Disorder
by Zhixiu Liu, Jia Zhang, Dongxia Fan, Ge Wang, Biao Wu, Lei Lei, Lina Wang, Jinzhuo Zhao and Jianmin Chen
Atmosphere 2023, 14(7), 1157; https://doi.org/10.3390/atmos14071157 - 17 Jul 2023
Viewed by 1037
Abstract
The coexistence of temperature changes and air pollution poses a severe global environmental issue, exacerbating health burdens. The aim of this study was to clarify the combined effects of ambient PM2.5 and cold exposure on the development of metabolic disorders. Male C57BL/6 [...] Read more.
The coexistence of temperature changes and air pollution poses a severe global environmental issue, exacerbating health burdens. The aim of this study was to clarify the combined effects of ambient PM2.5 and cold exposure on the development of metabolic disorders. Male C57BL/6 mice were randomly divided into four groups: TN-FA, TN-PM, TC-FA and TC-PM. The mice were then exposed to concentrated PM2.5 or filtered air (FA) under normal (22 °C) or cold (4 °C) environment conditions for 4 weeks. Metabolic-disorder-related indicators, blood pressure, serous lipids, fasting blood glucose and insulin, energy metabolism, mitochondria and protein expression in tissues were detected for comprehensively assessing metabolic disorder. The results showed that, compared to being exposed to PM2.5 only, when mice were exposed to both PM2.5 and the cold (non-optimal), they exhibited more significant metabolic disorders regarding glucose tolerance (p < 0.05), insulin resistance (p < 0.05), lipid metabolism, adipocytes (p < 0.01) and mitochondrial function. This study suggested that a cold environment might substantially exacerbate PM2.5-induced metabolic disorder. The interaction between temperature changes and air pollution implied that implementing the necessary environment-related policies is a critical and complex challenge. Full article
(This article belongs to the Section Air Quality)
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Graphical abstract

Graphical abstract
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<p>Exposure schematic (<b>a</b>–<b>d</b>), PM<sub>2.5</sub> concentrations (<b>e</b>), body weight (<b>f</b>), and blood pressure of different groups during exposure (<b>g</b>,<b>h</b>).</p>
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<p>Glucose tolerance and insulin resistance in mice after combined exposure to PM<sub>2.5</sub> and the cold. (<b>a</b>,<b>b</b>) Fasting blood glucose and insulin of mice. (<b>c</b>) HOMA-IR. (<b>d</b>) IPGTT. (<b>e</b>) ITT. * <span class="html-italic">p</span> &lt; 0.05, ** <span class="html-italic">p</span> &lt; 0.01, FA vs. PM; <sup>#</sup> <span class="html-italic">p</span> &lt; 0.05, T<sub>C</sub> vs. T<sub>N</sub>.</p>
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<p>Energy metabolism of mice by metabolic cage. (<b>a</b>–<b>d</b>) VO<sub>2</sub>, VCO<sub>2,</sub> RER and heat production in mice after combined exposure to PM<sub>2.5</sub> and the cold. * <span class="html-italic">p</span> &lt; 0.05, ** <span class="html-italic">p</span> &lt; 0.01, FA vs. PM; <sup>##</sup> <span class="html-italic">p</span> &lt; 0.01, T<sub>C</sub> vs. T<sub>N</sub>.</p>
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<p>Representative images of the H&amp;E staining of WAT (<b>a</b>) and BAT (<b>b</b>) in mice after combined exposure to PM<sub>2.5</sub> and the cold. Number and morphology of mitochondria in BAT of mice via transmission electron microscopy ((TEM, <b>c</b>–<b>f</b>). (<b>c</b>) The ratio of BAT weight to body weight in mice. (<b>d</b>) Morphology of mitochondria in BAT. (<b>e</b>) Area of mitochondria in BAT. (<b>f</b>) Number of mitochondria in BAT. * <span class="html-italic">p</span> &lt; 0.05, ** <span class="html-italic">p</span> &lt; 0.01, FA vs. PM; <sup>##</sup> <span class="html-italic">p</span> &lt; 0.01, T<sub>C</sub> vs. T<sub>N.</sub></p>
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<p>Blood lipids of mice. (<b>a</b>–<b>d</b>) TC, TG, LDL and HDL in the serum of mice after combined exposure to PM<sub>2.5</sub> and the cold. * <span class="html-italic">p</span> &lt; 0.05, FA vs. PM.</p>
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<p>Inflammatory cytokines and adipocytokines in the serum of mice. (<b>a</b>–<b>d</b>) IL-6, TNF-α, leptin and adiponectin in the serum of mice. * <span class="html-italic">p</span> &lt; 0.05, ** <span class="html-italic">p</span> &lt; 0.01, FA vs. PM; <sup>#</sup> <span class="html-italic">p</span> &lt; 0.05, <sup>##</sup> <span class="html-italic">p</span> &lt; 0.01, T<sub>C</sub> vs. T<sub>N.</sub></p>
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<p>Protein expression of UCP-1 and HSP90 in the WAT (<b>a</b>,<b>b</b>) and BAT (<b>c</b>,<b>d</b>) of mice after combined exposure to PM<sub>2.5</sub> and the cold. * <span class="html-italic">p</span> &lt; 0.05, ** <span class="html-italic">p</span> &lt; 0.01, FA vs. PM; <sup>#</sup> <span class="html-italic">p</span> &lt; 0.05, <sup>##</sup> <span class="html-italic">p</span> &lt; 0.01, T<sub>C</sub> vs. T<sub>N</sub>.</p>
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13 pages, 2840 KiB  
Article
Pericoronary Adipose Tissue Radiomics from Coronary Computed Tomography Angiography Identifies Vulnerable Plaques
by Justin N. Kim, Lia Gomez-Perez, Vladislav N. Zimin, Mohamed H. E. Makhlouf, Sadeer Al-Kindi, David L. Wilson and Juhwan Lee
Bioengineering 2023, 10(3), 360; https://doi.org/10.3390/bioengineering10030360 - 14 Mar 2023
Cited by 2 | Viewed by 2006
Abstract
Pericoronary adipose tissue (PCAT) features on Computed Tomography (CT) have been shown to reflect local inflammation and increased cardiovascular risk. Our goal was to determine whether PCAT radiomics extracted from coronary CT angiography (CCTA) images are associated with intravascular optical coherence tomography (IVOCT)-identified [...] Read more.
Pericoronary adipose tissue (PCAT) features on Computed Tomography (CT) have been shown to reflect local inflammation and increased cardiovascular risk. Our goal was to determine whether PCAT radiomics extracted from coronary CT angiography (CCTA) images are associated with intravascular optical coherence tomography (IVOCT)-identified vulnerable-plaque characteristics (e.g., microchannels (MC) and thin-cap fibroatheroma (TCFA)). The CCTA and IVOCT images of 30 lesions from 25 patients were registered. The vessels with vulnerable plaques were identified from the registered IVOCT images. The PCAT-radiomics features were extracted from the CCTA images for the lesion region of interest (PCAT-LOI) and the entire vessel (PCAT-Vessel). We extracted 1356 radiomic features, including intensity (first-order), shape, and texture features. The features were reduced using standard approaches (e.g., high feature correlation). Using stratified three-fold cross-validation with 1000 repeats, we determined the ability of PCAT-radiomics features from CCTA to predict IVOCT vulnerable-plaque characteristics. In the identification of TCFA lesions, the PCAT-LOI and PCAT-Vessel radiomics models performed comparably (Area Under the Curve (AUC) ± standard deviation 0.78 ± 0.13, 0.77 ± 0.14). For the identification of MC lesions, the PCAT-Vessel radiomics model (0.89 ± 0.09) was moderately better associated than the PCAT-LOI model (0.83 ± 0.12). In addition, both the PCAT-LOI and the PCAT-Vessel radiomics model identified coronary vessels thought to be highly vulnerable to a similar standard (i.e., both TCFA and MC; 0.88 ± 0.10, 0.91 ± 0.09). The most favorable radiomic features tended to be those describing the texture and size of the PCAT. The application of PCAT radiomics can identify coronary vessels with TCFA or MC, consistent with IVOCT. Furthermore, the use of CCTA radiomics may improve risk stratification by noninvasively detecting vulnerable-plaque characteristics that are only visible with IVOCT. Full article
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Figure 1
<p>Three-dimensional (3D) visualization of IVOCT coronary-artery segments with (<b>A</b>) TCFA and (<b>B</b>) MC. A heatmap of fibrous-cap thickness is overlayed in (<b>A</b>), showing the TCFA region. As described in the text, TCFA (red) was defined as a plaque with a fibrous cap &lt; 65 µm and TCFA angle &gt; 90° for each frame. The MC was detected as described in the text. In this instance, there were three microvessels (blue) in this plaque. The microvessels’ segments were 7.4 mm in length and their diameters were approximately 10.4 µm. Multiple radiomic features captured the extent of TCFA and microvessel presence in plaques.</p>
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<p>Registration of CCTA and IVOCT images. In panel (<b>A</b>), 3D CCTA coronary vessel (<b>top</b>), the straightened CCTA (<b>middle</b>), and the IVOCT coronary vessel (<b>bottom</b>). Registration was performed using our developed software, OCTOPUS. Note that the white calcified plaques in the straightened CCTA view correspond to matching calcifications in IVOCT, demonstrating good registration. In panel (<b>B</b>), an IVOCT axial frame of a non-calcified lesion is shown. Panel (<b>C</b>) shows a registered CCTA axial frame overlayed with HU colormap segmentation of PCAT.</p>
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<p>Univariate CCTA-feature analysis for predicting IVOCT-TCFA. Manhattan plot of PCAT-LOI (<b>A</b>) and PCAT-Vessel (<b>B</b>) of the mean AUCs for the identification of coronary vessels with IVOCT-TCFA. The number of radiomic features with AUC &gt; 0.5 for identification of coronary vessels with IVOCT-TCFA was 147/293 (50.2%) for PCAT-LOI and 99/341 (29.0%) for PCAT-Vessel. Of the 147 PCAT-LOI-radiomics features with AUC &gt; 0.5, 14 (9.5%) were shape features, 21 (14.3%) were first-order statistics, and 112 (76.2%) were texture-based features (GLCM: 18, GLDM: 21, GLRLM: 16, GLSZM: 51, NGTDM: 6). Of the 99 PCAT-Vessel-radiomics features with AUC &gt; 0.5, eight (8.1%) were shape features, thirteen (13.1%) were first-order statistics, and seventy-eight (78.8%) were texture-based features (GLCM: 11, GLDM: 16, GLRLM: 19, GLSZM: 27, NGTDM: 5).</p>
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<p>Univariate CCTA-radiomics feature analysis for predicting IVOCT-MC. Manhattan plot of PCAT-LOI (<b>A</b>) and PCAT-Vessel (<b>B</b>) of the mean AUCs for the identification of coronary vessels with IVOCT-MC. The number of radiomic features with AUC &gt; 0.5 for identification of coronary vessels with IVOCT-MC was 195/293 (66.6%) for PCAT-LOI and 203/341 (59.5%) for PCAT-Vessel. Of 195 radiomic features with AUC &gt; 0.5 from the PCAT-LOI, 31 (15.9%) were shape features, 27 (13.9%) were first-order statistics, and 137 (70.3%) were texture-based features (GLCM: 16, GLDM: 26, GLRLM: 19, GLSZM: 63, NGTDM: 13). Of 203 radiomic features from the PCAT-Vessel, 32 (15.8%) were shape features, 19 (9.4%) were first-order statistics, and 152 (74.9%) were texture-based features (GLCM: 24, GLDM: 28, GLRLM: 21, GLSZM: 67, NGTDM: 12).</p>
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<p>Multivariate analysis of CCTA PCAT-radiomic features associated with IVOCT vulnerable-plaque characteristics on IVOCT. Diagnostic performance obtained from the three-fold cross-validation with 1000 repeats for the identification of (<b>A</b>) IVOCT-TCFA, (<b>B</b>) IVOCT-MC, and (<b>C</b>) IVOCT-TCFA-MC (IVOCT-Vulnerable). The ROC curves of PCAT-radiomics models for PCAT-LOI and PCAT-Vessel are plotted, and the mean AUC and SD are reported.</p>
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13 pages, 1819 KiB  
Article
Distinctive Morphological Patterns of Complicated Coronary Plaques in Acute Coronary Syndromes: Insights from an Optical Coherence Tomography Study
by Horea-Laurentiu Onea, Mihail Spinu, Calin Homorodean, Maria Olinic, Florin-Leontin Lazar, Mihai Claudiu Ober, Diana Stoian, Lucian Mihai Itu and Dan Mircea Olinic
Diagnostics 2022, 12(11), 2837; https://doi.org/10.3390/diagnostics12112837 - 17 Nov 2022
Cited by 4 | Viewed by 1723
Abstract
Optical coherence tomography (OCT) is an ideal imaging technique for assessing culprit coronary plaque anatomy. We investigated the morphological features and mechanisms leading to plaque complication in a single-center observational retrospective study on 70 consecutive patients with an established diagnosis of acute coronary [...] Read more.
Optical coherence tomography (OCT) is an ideal imaging technique for assessing culprit coronary plaque anatomy. We investigated the morphological features and mechanisms leading to plaque complication in a single-center observational retrospective study on 70 consecutive patients with an established diagnosis of acute coronary syndrome (ACS) who underwent OCT imaging after coronary angiography. Three prominent morphological entities were identified. Type I or intimal discontinuity, which was found to be the most common mechanism leading to ACS and was seen in 35 patients (50%), was associated with thrombus (68.6%; p = 0.001), mostly affected the proximal plaque segment (60%; p = 0.009), and had no distinctive underlying plaque features. Type II, a significant stenosis with vulnerability features (inflammation in 16 patients, 84.2%; thin-cap fibroatheroma (TCFA) in 10 patients, 52.6%) and a strong association with lipid-rich plaques (94.7%; p = 0.002), was observed in 19 patients (27.1%). Type III, a protrusive calcified nodule, which was found to be the dominant morphological pattern in 16 patients (22.9%), was found in longer plaques (20.8 mm vs. 16.8 mm ID vs. 12.4 mm SS; p = 0.04) and correlated well with TCFA (93.8%; p = 0.02) and inflammation (81.3%). These results emphasize the existence of a wide spectrum of coronary morphological patterns related to ACS. Full article
(This article belongs to the Section Optical Diagnostics)
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<p>Patient flow chart.</p>
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<p>Representative OCT images of culprit lesions. (<b>A</b>) Plaque rupture with a disrupted fibrous cap (arrow) and a clear cavity (star). (<b>B</b>) Plaque erosion. White thrombus (white arrow) overlying a thin fibrous cap (blue arrow) and calcium sheets (star), with no evidence of rupture. (<b>C</b>) Significant stenosis within lipid-rich plaque (star), which exhibits signs of macrophage infiltration (arrow). (<b>D</b>) Calcified nodule (white star) with adjacent calcium sheets (blue star).</p>
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<p>Main correlations for each patient group.</p>
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<p>Topography of intraplaque complication.</p>
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<p>Underlying plaque configuration of intimal discontinuities.</p>
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11 pages, 306 KiB  
Article
Antibiotic Resistance in Non-Typhoidal Salmonella enterica Strains Isolated from Chicken Meat in Indonesia
by Minori Takaichi, Kayo Osawa, Ryohei Nomoto, Noriko Nakanishi, Masanori Kameoka, Makiko Miura, Katsumi Shigemura, Shohiro Kinoshita, Koichi Kitagawa, Atsushi Uda, Takayuki Miyara, Ni Made Mertaniasih, Usman Hadi, Dadik Raharjo, Ratna Yulistiani, Masato Fujisawa, Kuntaman Kuntaman and Toshiro Shirakawa
Pathogens 2022, 11(5), 543; https://doi.org/10.3390/pathogens11050543 - 4 May 2022
Cited by 6 | Viewed by 2430
Abstract
The increase in antibiotic resistance in non-typhoidal Salmonella enterica (NTS) has been confirmed in Indonesia by this study. We confirmed the virulence genes and antimicrobial susceptibilities of clinical NTS (n = 50) isolated from chicken meat in Indonesia and also detected antimicrobial [...] Read more.
The increase in antibiotic resistance in non-typhoidal Salmonella enterica (NTS) has been confirmed in Indonesia by this study. We confirmed the virulence genes and antimicrobial susceptibilities of clinical NTS (n = 50) isolated from chicken meat in Indonesia and also detected antimicrobial resistance genes. Of 50 strains, 30 (60%) were non-susceptible to nalidixic acid (NA) and all of them had amino acid mutations in gyrA. Among 27 tetracycline (TC) non-susceptible strains, 22 (81.5%) had tetA and/or tetB. The non-susceptibility rates to ampicillin, gentamicin or kanamycin were lower than that of NA or TC, but the prevalence of blaTEM or aadA was high. Non-susceptible strains showed a high prevalence of virulence genes compared with the susceptible strains (tcfA, p = 0.014; cdtB, p < 0.001; sfbA, p < 0.001; fimA, p = 0.002). S. Schwarzengrund was the most prevalent serotype (23 strains, 46%) and the most frequently detected as multi-antimicrobial resistant. The prevalence of virulence genes in S. Schwarzengrund was significantly higher than other serotypes in hlyE (p = 0.011) and phoP/Q (p = 0.011) in addition to the genes above. In conclusion, NTS strains isolated from Indonesian chicken had a high resistance to antibiotics and many virulence factors. In particular, S. Schwarzengrund strains were most frequently detected as multi-antimicrobial resistant and had a high prevalence of virulence genes. Full article
25 pages, 3517 KiB  
Review
Detection of Vulnerable Coronary Plaques Using Invasive and Non-Invasive Imaging Modalities
by Anna van Veelen, Niels M. R. van der Sangen, Ronak Delewi, Marcel A. M. Beijk, Jose P. S. Henriques and Bimmer E. P. M. Claessen
J. Clin. Med. 2022, 11(5), 1361; https://doi.org/10.3390/jcm11051361 - 1 Mar 2022
Cited by 19 | Viewed by 5867
Abstract
Acute coronary syndrome (ACS) mostly arises from so-called vulnerable coronary plaques, particularly prone for rupture. Vulnerable plaques comprise a specific type of plaque, called the thin-cap fibroatheroma (TFCA). A TCFA is characterized by a large lipid-rich necrotic core, a thin fibrous cap, inflammation, [...] Read more.
Acute coronary syndrome (ACS) mostly arises from so-called vulnerable coronary plaques, particularly prone for rupture. Vulnerable plaques comprise a specific type of plaque, called the thin-cap fibroatheroma (TFCA). A TCFA is characterized by a large lipid-rich necrotic core, a thin fibrous cap, inflammation, neovascularization, intraplaque hemorrhage, microcalcifications or spotty calcifications, and positive remodeling. Vulnerable plaques are often not visible during coronary angiography. However, different plaque features can be visualized with the use of intracoronary imaging techniques, such as intravascular ultrasound (IVUS), potentially with the addition of near-infrared spectroscopy (NIRS), or optical coherence tomography (OCT). Non-invasive imaging techniques, such as computed tomography coronary angiography (CTCA), cardiovascular magnetic resonance (CMR) imaging, and nuclear imaging, can be used as an alternative for these invasive imaging techniques. These invasive and non-invasive imaging modalities can be implemented for screening to guide primary or secondary prevention therapies, leading to a more patient-tailored diagnostic and treatment strategy. Systemic pharmaceutical treatment with lipid-lowering or anti-inflammatory medication leads to plaque stabilization and reduction of cardiovascular events. Additionally, ongoing studies are investigating whether modification of vulnerable plaque features with local invasive treatment options leads to plaque stabilization and subsequent cardiovascular risk reduction. Full article
(This article belongs to the Special Issue Percutaneous Coronary Interventions in Acute Coronary Syndromes)
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<p>The vulnerable plaque consists of a large lipid-rich necrotic core with a thin fibrous cap (&lt;65 μm). Several plaque features can be present that are associated with increased risk for cardiovascular events, including outward vessel remodeling, microcalcifications and spotty calcifications, hemorrhage, neovascularization, and inflammation. Image adapted from Van Veelen et al. Reviews in Cardiovascular Medicine 2022. CC-BY [4.0] [<a href="#B9-jcm-11-01361" class="html-bibr">9</a>].</p>
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<p>Vulnerable plaque on IVUS. An intravascular ultrasound (IVUS) cross-section of the coronary artery demonstrating the vulnerable plaque features that can be visualized with IVUS. The plaque demonstrates a plaque burden that is greater than 70%, measured as the external elastic membrane (EEM) area (green line) minus the luminal area (red line), divided by the EEM. The plaque appears echolucent, indicating the presence of a large lipid core and deep echo attenuation is visible. Furthermore, microcalcifications and outward vessel remodeling can be observed.</p>
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<p>Vulnerable plaque on OCT. A cross-section of the coronary artery with OCT demonstrates a low-signal region, marked with asterisks, corresponding with a lipid-rich plaque. The overlying bright structure corresponds with the fibrous cap (arrowheads). (<b>A</b>) displays a lipid-rich plaque with a thin fibrous cap (i.e., thin-cap fibroatheroma). (<b>B</b>) displays a lipid-rich plaque with thick fibrous tissue overlaying the lipid-rich core. Image obtained from Muramatsu Y. et al., IJC Heart &amp; Vasculature 2019. CC-BY [4.0] [<a href="#B71-jcm-11-01361" class="html-bibr">71</a>].</p>
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<p>Vulnerable plaque on NIRS-IVUS. (<b>A</b>) displays an intravascular ultrasound (IVUS) image, which demonstrates an echolucent plaque with deep echo attenuation and a large plaque burden of 74%. The red-to-yellow colored ring corresponds with near-infrared spectroscopy (NIRS) data. The ring colors yellow at the site of the soft plaque, indicating that the plaque corresponds with a high probability for lipid core. In (<b>B</b>), the corresponding NIRS chemogram is displayed, where a maximum lipid-core burden index in a segment of 4 mm (maxLCBImm4) is detected of 543 at around 55 mm of the pullback, corresponding with the definition of a lipid-rich plaque (maxLCBImm4 &gt; 400), based on the LRP study [<a href="#B79-jcm-11-01361" class="html-bibr">79</a>]. Image adapted from Van Veelen et al. Reviews in Cardiovascular Medicine 2022. CC-BY [4.0] [<a href="#B9-jcm-11-01361" class="html-bibr">9</a>].</p>
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<p>Vulnerable plaque on CTCA. (<b>A</b>) displays the left anterior descending artery on computed tomography coronary angiography (CTCA) of a patient with stable angina pectoris. A low-attenuation plaque is demonstrated with spotty calcification. (<b>B</b>) displays the intravascular ultrasound (IVUS) images with near-infrared spectroscopy (NIRS) of the same patient, corresponding with the cutline in (<b>A</b>) around the bifurcation. The IVUS image displays an echolucent plaque (*) with deep echo attenuation and small calcium deposits. The NIRS chemogram colors yellow, indicating the presence of a large lipid core. Image obtained from Van Veelen et al. Reviews in Cardiovascular Medicine 2022. CC-BY [4.0] [<a href="#B9-jcm-11-01361" class="html-bibr">9</a>].</p>
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<p>High-risk plaque features on CTCA according to CAD-RADS™: Coronary Artery Disease-Reporting and Data System. (<b>A</b>) demonstrates spotty calcifications; (<b>B</b>) demonstrates the napkin-ring sign, i.e., plaque with low attenuation in the center and a peripheral rim of high attenuation (indicated with arrows); (<b>C</b>) demonstrates positive remodeling, which is present if the ratio of the vessel diameter at the location of the plaque (Av), in relation to the vessel diameter proximally (Ap) and distally from the plaque (Ad) is greater than 1.1; (<b>D</b>) demonstrates a low-attenuation plaque, with Hounsfield Units (HU) of &lt;30. Reprinted from Cury et al. [<a href="#B116-jcm-11-01361" class="html-bibr">116</a>], with permission from Elsevier.</p>
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<p>Vulnerable plaque on <sup>18</sup>F-NaF PET imaging. In (<b>A</b>), coronary angiography demonstrates two non-obstructive lesions in the proximal and mid-right coronary artery in a patient with stable angina. (<b>B</b>) demonstrates the corresponding <sup>18</sup>F-NaF PET-CT image, which indicates no uptake of <sup>18</sup>F-NaF in lesion I, but an increased uptake in lesion II. (<b>C</b>) and (<b>D</b>) demonstrate the corresponding radiofrequency IVUS images. Lesion I (<b>C</b>) appears to be a lesion consisting of fibrous tissue (green) with confluent calcium (white) with acoustic shadowing. However, the <sup>18</sup>F-NaF positive lesion II (<b>D</b>) appears to consist of a large necrotic core (red), with microcalcifications (white), suggestive for a vulnerable plaque. Image adapted from Joshi NV, et al. [<a href="#B139-jcm-11-01361" class="html-bibr">139</a>] CC-BY [4.0].</p>
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<p>Hybrid imaging in a patient presenting with recurrent non-ST-segment elevation ACS. (<b>A</b>) demonstrates severe in-stent restenosis in the proximal right coronary artery (RCA) with de novo lesion in the mid-RCA; (<b>B</b>) OCT demonstrates plaque rupture in the mid-RCA and (<b>C</b>) severe neointimal hyperplasia in the previously placed stent in the proximal RCA. (<b>D</b>) demonstrates the result of successful revascularization, with remaining diffuse disease in the left coronary artery (<b>E</b>). (<b>F</b>,<b>G</b>) demonstrate the <sup>18</sup>F-NaF PET-CT images with high <sup>18</sup>F-NaF uptake in the culprit artery, especially in the culprit lesion in the proximal RCA. The left coronary artery demonstrates no uptake of the radioactive tracer. Reprinted from Bing et al. [<a href="#B141-jcm-11-01361" class="html-bibr">141</a>], with permission from Elsevier.</p>
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26 pages, 1164 KiB  
Review
Current Advances in the Diagnostic Imaging of Atherosclerosis: Insights into the Pathophysiology of Vulnerable Plaque
by Nataliya V. Mushenkova, Volha I. Summerhill, Dongwei Zhang, Elena B. Romanenko, Andrey V. Grechko and Alexander N. Orekhov
Int. J. Mol. Sci. 2020, 21(8), 2992; https://doi.org/10.3390/ijms21082992 - 23 Apr 2020
Cited by 55 | Viewed by 8331
Abstract
Atherosclerosis is a lipoprotein-driven inflammatory disorder leading to a plaque formation at specific sites of the arterial tree. After decades of slow progression, atherosclerotic plaque rupture and formation of thrombi are the major factors responsible for the development of acute coronary syndromes (ACSs). [...] Read more.
Atherosclerosis is a lipoprotein-driven inflammatory disorder leading to a plaque formation at specific sites of the arterial tree. After decades of slow progression, atherosclerotic plaque rupture and formation of thrombi are the major factors responsible for the development of acute coronary syndromes (ACSs). In this regard, the detection of high-risk (vulnerable) plaques is an ultimate goal in the management of atherosclerosis and cardiovascular diseases (CVDs). Vulnerable plaques have specific morphological features that make their detection possible, hence allowing for identification of high-risk patients and the tailoring of therapy. Plaque ruptures predominantly occur amongst lesions characterized as thin-cap fibroatheromas (TCFA). Plaques without a rupture, such as plaque erosions, are also thrombi-forming lesions on the most frequent pathological intimal thickening or fibroatheromas. Many attempts to comprehensively identify vulnerable plaque constituents with different invasive and non-invasive imaging technologies have been made. In this review, advantages and limitations of invasive and non-invasive imaging modalities currently available for the identification of plaque components and morphologic features associated with plaque vulnerability, as well as their clinical diagnostic and prognostic value, were discussed. Full article
(This article belongs to the Section Molecular Pathology, Diagnostics, and Therapeutics)
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Graphical abstract

Graphical abstract
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<p>The utility of grayscale IVUS, VH-IVUS, OCT, and NIRS in the visualization of a vulnerable plaque. Note: IVUS—intravascular ultrasound; NIRS—near infrared spectroscopy; OCT—optical coherence tomography; PB—plaque burden; TCFA—thin-cap fibroatheroma; VH-IVUS—virtual histology intravascular ultrasound.</p>
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<p>Schematic representation of morphological components of a vulnerable plaque that can be detected both by invasive and non-invasive imaging modalities. Note: CT—computed tomography; FLIM—fluorescence lifetime imaging microscopy; IVPA—intravascular photoacoustic imaging; IVUS—intravascular ultrasound; MRI—magnetic resonance imaging; NIRF—near-infrared fluorescence; NIRS—near infrared spectroscopy; OCT—optical coherence tomography; PET—positron emission tomography.</p>
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36 pages, 8764 KiB  
Article
Thin Cap Fibroatheroma Detection in Virtual Histology Images Using Geometric and Texture Features
by Zahra Rezaei, Ali Selamat, Arash Taki, Mohd Shafry Mohd Rahim, Mohammed Rafiq Abdul Kadir, Marek Penhaker, Ondrej Krejcar, Kamil Kuca, Enrique Herrera-Viedma and Hamido Fujita
Appl. Sci. 2018, 8(9), 1632; https://doi.org/10.3390/app8091632 - 12 Sep 2018
Cited by 7 | Viewed by 4506
Abstract
Atherosclerotic plaque rupture is the most common mechanism responsible for a majority of sudden coronary deaths. The precursor lesion of plaque rupture is thought to be a thin cap fibroatheroma (TCFA), or “vulnerable plaque”. Virtual Histology-Intravascular Ultrasound (VH-IVUS) images are clinically available for [...] Read more.
Atherosclerotic plaque rupture is the most common mechanism responsible for a majority of sudden coronary deaths. The precursor lesion of plaque rupture is thought to be a thin cap fibroatheroma (TCFA), or “vulnerable plaque”. Virtual Histology-Intravascular Ultrasound (VH-IVUS) images are clinically available for visualising colour-coded coronary artery tissue. However, it has limitations in terms of providing clinically relevant information for identifying vulnerable plaque. The aim of this research is to improve the identification of TCFA using VH-IVUS images. To more accurately segment VH-IVUS images, a semi-supervised model is developed by means of hybrid K-means with Particle Swarm Optimisation (PSO) and a minimum Euclidean distance algorithm (KMPSO-mED). Another novelty of the proposed method is fusion of different geometric and informative texture features to capture the varying heterogeneity of plaque components and compute a discriminative index for TCFA plaque, while the existing research on TCFA detection has only focused on the geometric features. Three commonly used statistical texture features are extracted from VH-IVUS images: Local Binary Patterns (LBP), Grey Level Co-occurrence Matrix (GLCM), and Modified Run Length (MRL). Geometric and texture features are concatenated in order to generate complex descriptors. Finally, Back Propagation Neural Network (BPNN), kNN (K-Nearest Neighbour), and Support Vector Machine (SVM) classifiers are applied to select the best classifier for classifying plaque into TCFA and Non-TCFA. The present study proposes a fast and accurate computer-aided method for plaque type classification. The proposed method is applied to 588 VH-IVUS images obtained from 10 patients. The results prove the superiority of the proposed method, with accuracy rates of 98.61% for TCFA plaque. Full article
(This article belongs to the Special Issue Deep Learning and Big Data in Healthcare)
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<p>Proposed approach (LBP: Local Binary Patterns feature; GLCM: Grey Level Co-occurrence Matrix feature; and MRL: Modified Run Length feature).</p>
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<p>(<b>a</b>) VH-IVUS image, (<b>b</b>) thresholding, (<b>c</b>) edge detection, (<b>d</b>) region growing, (<b>e</b>) level set, and (<b>f</b>) active contour (sank).</p>
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<p>Clustering by K-means, (<b>a</b>) cluster 1, (<b>b</b>) cluster 2, (<b>c</b>) cluster 3, and (<b>d</b>) cluster 4.</p>
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<p>Pseudo-code of the KMPSO model.</p>
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<p>Outliers in an NC image: (<b>a</b>) original image, and (<b>b</b>) zoomed area.</p>
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<p>Pseudo-code for the proposed pixel classification using the mED algorithm.</p>
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<p>Segmentation by KMPSO-mED: (<b>a</b>) overlapped tissue, and (<b>b</b>) segmented area.</p>
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<p>The average SW obtained by FCM, K-means, and SOM algorithms for Patients 1, 2, and 5.</p>
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<p>Comparison of KMPSO-mED, HFCM-mED for 10 Patients.</p>
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<p>Comparison of the FCMPSO-mED, KMPSO-mED, and HFCM-kNN models.</p>
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<p>Different tissue types in the plaque area of IVUS images: (<b>a</b>) dense calcium, (<b>b</b>) necrotic core, and (<b>c</b>) fibro-fatty.</p>
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<p>Accuracy measures of multiple classifiers obtained using geometrical features.</p>
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<p>Combined features using geometric and texture features.</p>
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<p>Results of SVM using geometrical and LBP features (<span class="html-italic">LBP</span><sub>1</sub><span class="html-italic">: LBP</span><sub>8,1</sub>, <span class="html-italic">LBP</span><sub>2</sub>: <span class="html-italic">GF_LBP</span><sub>8,1</sub>, <span class="html-italic">LBP</span><sub>3</sub>: <span class="html-italic">GF_LBP</span><sub>8,1</sub><span class="html-italic">_PCA</span>, <span class="html-italic">LBP</span><sub>4</sub>: <span class="html-italic">LBP</span><sub>16,2</sub>, <span class="html-italic">LBP</span><sub>5</sub>: <span class="html-italic">GF_LBP</span><sub>16,1</sub>, <span class="html-italic">LBP</span><sub>6</sub>: <span class="html-italic">GF_LBP</span><sub>16,1</sub> <span class="html-italic">_PCA,</span> Acc: accuracy, Sn: sensitivity, Sp: specificity, Pr: precision, and FS: F-score).</p>
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<p>Results of SVM using combined geometric and GLCM features (<span class="html-italic">GLCM</span><sub>1</sub>: GLCM<sub>0</sub>, GF_<span class="html-italic">GLCM</span><sub>2</sub>: GLCM<sub>0</sub>, <span class="html-italic">GLCM</span><sub>3</sub>: GF_GLCM<sub>0</sub>_PCA, <span class="html-italic">GLCM</span><sub>4</sub>: GLCM<sub>45</sub>), <span class="html-italic">GLCM</span><sub>5</sub>: GF_GLCM<sub>45</sub>, GF_GLCM<sub>45</sub>_PCA (<span class="html-italic">GLCM</span><sub>6</sub>), GLCM<sub>90</sub> (<span class="html-italic">GLCM</span><sub>7</sub>), GF_GLCM<sub>90</sub> (<span class="html-italic">GLCM</span><sub>8</sub>), GF_GLCM<sub>90</sub>_PCA (<span class="html-italic">GLCM</span><sub>9</sub>), GLCM<sub>135</sub> (<span class="html-italic">GLCM</span><sub>10</sub>), GF_GLCM<sub>135</sub> (<span class="html-italic">GLCM</span><sub>11</sub>), GF_GLCM<sub>135</sub>_PCA (<span class="html-italic">GLCM</span><sub>12</sub>), Acc: accuracy, Sn: sensitivity, Sp: specificity, Pr: precision, and FS: F-score).</p>
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<p>Results of SVM using geometric and MRL features (<span class="html-italic">MRL</span><sub>1</sub>: MRL<sub>0</sub><span class="html-italic">, MRL</span><sub>2</sub>: GF_MRL<sub>0</sub><span class="html-italic">, MRL</span><sub>3</sub>: GF_MRL<sub>0</sub>_PCA<span class="html-italic">, MRL</span><sub>4</sub>: MRL<sub>45</sub><span class="html-italic">, MRL</span><sub>4</sub>: MRL<sub>45</sub>, <span class="html-italic">MRL</span><sub>5</sub>: GF_MRL<sub>45</sub><span class="html-italic">, MRL</span><sub>6</sub>: GF_MRL<sub>45</sub>_PCA,<span class="html-italic">MRL</span><sub>7</sub>: MRL<sub>90</sub><span class="html-italic">, MRL</span><sub>8</sub>: GF_MRL<sub>90</sub><span class="html-italic">, MRL</span><sub>9</sub>: GF_MRL<sub>90</sub>_PCA<span class="html-italic">, MRL</span><sub>10</sub>: MRL<sub>135</sub>, <span class="html-italic">MRL</span><sub>11</sub>: GF_MRL<sub>135</sub> ,<span class="html-italic">MRL</span><sub>12</sub>: GF_MRL<sub>135</sub>_PCA, Acc: accuracy, Sn: sensitivity, Sp: specificity, Pr: precision, and FS: F-score).</p>
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<p>The best accuracy of geometric and texture features.</p>
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