In this study, the investigator propose to determine the efficiency of a new and more sophisticated imaging prototype, the Spectral Photon Counting Computed Tomography (SPCCT), at characterizing vulnerable plaques and luminal stenosis in Carotid Atherosclerosis patients compared to DECT (Dual Energy CT) and MRI (Magnetic Resonance Imaging) which are used in current practice
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
SINGLE
Enrollment
22
The acquisition for the assessment of the brain parenchyma and for the evaluation of the cervical and intracranial arteries will be performed without and with iodine based contrast media, respectively. The same parameters will be used for both conditions but for a large volume, from the aortic arch to the top of the head. The iodinate contrast agent's injection (Iomeron 400, Bracco Imaging France) will be performed at 5mL/s into an 18G catheter, followed by a 20 mL saline flush that will be injected at the same rate. The bolus volume will be determined according to the patient's body weight : 70 mL for patients \< 80 kg and 1 mL/kg for patients \> 80 kg, with a maximum of 90 mL. The SPCCT scanner is a prototype spectral photon-counting computed tomography system derived from a modified clinical CT system with a field of View (FOV) of 168 mm in-plane, and a z-coverage of 2 mm.
The acquisition for the assessment of the brain parenchyma and for the evaluation of the cervical and intracranial arteries will be performed without and with iodine based contrast media, respectively. The same parameters will be used for both conditions but for a large volume, from the aortic arch to the top of the head. The iodinate contrast agent's injection (Iomeron 400, Bracco Imaging France) will be performed at 5mL/s into an 18G catheter, followed by a 20 mL saline flush that will be injected at the same rate. The bolus volume will be determined according to the patient's body weight : 70 mL for patients \< 80 kg and 1 mL/kg for patients \> 80 kg, with a maximum of 90 mL. DECT : IQon, Philips
Louis Pradel cardiovascular Hospital
Bron, France
Lipid Necrotic Core (LNC) in mm² identified with SPCCT
measurement of the height and thickness of surface of the plaque's components
Time frame: 1 month
Lipid Necrotic Core (LNC) in mm² identified with DECT
measurement of the height and thickness of surface of the plaque's components
Time frame: 1 month
Lipid Necrotic Core (LNC) in mm² identified with histology
measurement of the height and thickness of surface of the plaque's components
Time frame: 1 month
Intra Plaque Hemorrhage (IPH) in mm² identified with SPCCT
measurement of the height and thickness of surface of the plaque's components
Time frame: 1 month
Intra Plaque Hemorrhage (IPH) in mm² identified with DECT
measurement of the height and thickness of surface of the plaque's components
Time frame: 1 month
Intra Plaque Hemorrhage (IPH) identified with histology
measurement of the height and thickness of surface of the plaque's components
Time frame: 1 month
Fibrous Cap Ulceration (FCU) in mm² identified with SPCCT
measurement of the height and thickness of surface of the plaque's components
Time frame: 1 month
Fibrous Cap Ulceration (FCU) in mm² identified with DECT
measurement of the height and thickness of surface of the plaque's components
Time frame: 1 month
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Fibrous Cap Ulceration (FCU) in mm² identified with histology
measurement of the height and thickness of surface of the plaque's components
Time frame: 1 month
Number of irregularities identified with SPCCT
\- Irregularities as defined by \< 2 mm indentation, fissure, or erosion on the luminal surface of a plaque, exposing a portion of the inner plaque to direct contact with circulating blood.
Time frame: 1 month
Number of irregularities identified with DECT
\- Irregularities as defined by \< 2 mm indentation, fissure, or erosion on the luminal surface of a plaque, exposing a portion of the inner plaque to direct contact with circulating blood.
Time frame: 1 month
Number of irregularities identified with MRI
\- Irregularities as defined by \< 2 mm indentation, fissure, or erosion on the luminal surface of a plaque, exposing a portion of the inner plaque to direct contact with circulating blood.
Time frame: 1 month
Number of ulcerations identified with SPCCT
\- Ulceration as defined by \> 2 mm indentation, fissure, or erosion on the luminal surface of a plaque, exposing a portion of the inner plaque to direct contact with circulating blood.
Time frame: 1 month
Number of ulcerations identified with DECT
\- Ulceration as defined by \> 2 mm indentation, fissure, or erosion on the luminal surface of a plaque, exposing a portion of the inner plaque to direct contact with circulating blood.
Time frame: 1 month
Number of ulcerations identified with MRI
\- Ulceration as defined by \> 2 mm indentation, fissure, or erosion on the luminal surface of a plaque, exposing a portion of the inner plaque to direct contact with circulating blood.
Time frame: 1 month
Assessable vascular segments with lack of image artifacts
It will be assessed by estimating the image quality on scale from 1 to 4 (1 = poor, 2 = moderate, 3 = good, and 4 = excellent)
Time frame: 1 month
radiation dose received during SPCCT
Time frame: 1 month
radiation dose received during DECT
Time frame: 1 month
Tolerance to SPCCT assessed by a tolerance survey
1 to 10, 1= very bad, 10= very good. Survey adapted from Sparrow et al., Journal of magnetic resonance imaging 19:410-416, 2004
Time frame: 1 month
Tolerance to DECT assessed by a tolerance survey
1 to 10, 1= very bad, 10= very good. Survey adapted from Sparrow et al., Journal of magnetic resonance imaging 19:410-416, 2004
Time frame: 1 month
Tolerance to MRI assessed by a tolerance survey
1 to 10, 1= very bad, 10= very good. Survey adapted from Sparrow et al., Journal of magnetic resonance imaging 19:410-416, 2004
Time frame: 1 month