VALID-PET-CT

  • Research type

    Research Study

  • Full title

    Development and Validation of a Fast, Semi-Automated Hybrid Imaging Platform to Assess Coronary Atherosclerotic Plaque Morphology, Endothelial Shear Stress and Arterial Inflammation: A Proof of Principle Study

  • IRAS ID

    252584

  • Contact name

    Christos Bourantas

  • Contact email

    c.bourantas@nhs.net

  • Sponsor organisation

    Barts Health NHS Trust

  • Duration of Study in the UK

    0 years, 5 months, 1 days

  • Research summary

    Summary of Research

    Imaging the inside of coronary arteries (intravascular imaging) offers great insight into the assessment and treatment of coronary artery disease. Over time, substances such as fat, cholesterol and calcium can build up into ‘plaques’ in the arteries, causing narrowings or even blockages. These plaques can also rupture, causing cardiovascular events such as heart attacks or strokes. By using ultrasound and infrared technology, intravascular imaging can help assess these plaques, however this is an invasive technique involving angiography.

    Another indicator of plaque morphology and stability is endothelial shear stress (ESS) and arterial inflammation. We have pioneered novel non-invasive methods for modelling ESS using computed tomography coronary angiography (CTCA), as well as imaging coronary arterial inflammation using a positron emission tomography (PET) scan. Before embarking upon a large-scale clinical outcome study to determine whether the combined assessment of plaque morphology, ESS and arterial inflammation can improve risk prediction, we need to perform a proof-of-principle study to further develop our methodology for hybrid image analysis, and to validate this technique against high-resolution intravascular imaging as a surrogate marker of histology.

    Summary of Results

    The study recruited 20 patients of whom 19 completed the protocol for the images we planned to acquire (one patient withdrew for personal reasons). Our study included 63 vessels of which 58 were available for a final analysis.
    In summary we found that features of cholesterol-based heart artery narrowings (plaques) were best detectable with imaging directly using invasive devices from within the arteries of the vessels, and not effectively detected using a combination of nuclear medicine
    imaging with specialised tracers for detecting these plaques and traditional CT scanning images. We also found that we could effectively collect, combine and analyse these data to validate the effectiveness of the non-invasive imaging.

  • REC name

    London - Dulwich Research Ethics Committee

  • REC reference

    19/LO/1086

  • Date of REC Opinion

    23 Sep 2019

  • REC opinion

    Further Information Favourable Opinion