In vivo assessment of intraplaque and endothelial fibrin in ApoE−/− mice by molecular MRI

ObjectiveMolecular magnetic resonance imaging (MRI) has emerged as a promising non-invasive modality to characterize atherosclerotic vessel wall changes on a morphological and molecular level. Intraplaque and endothelial fibrin has recently been recognized to play an important role in the progression of atherosclerosis. This study aimed to investigate the feasibility of intraplaque and endothelial fibrin detection using a fibrin-targeted contrast-agent, FTCA (EPIX Pharmaceuticals, Lexington, MA), in a mouse model of atherosclerosis.MethodsMale apolipoproteinE-knockout mice (ApoE−/−) were fed a high fat diet (HFD) for one to three months. MRI of the brachiocephalic artery was performed prior to and 90 min after the administration of FTCA (n = 8 per group). Contrast to noise ratios (CNR) and longitudinal relaxation rates (R1) of plaques were determined and compared to ex vivo fibrin density measurements on immunohistological sections stained with a fibrin-specific antibody and gadolinium concentrations measured by inductively coupled mass spectroscopy (ICP-MS).ResultsMolecular MRI after FTCA administration demonstrated a significant increase (p < 0.05) in contrast agent uptake in brachiocephalic artery plaques. In vivo CNR measurements were in good agreement with ex vivo fibrin density measurements on immunohistochemistry (y = 2.4x + 11.3, R2 = 0.82) and ICP-MS (y = 0.95x + 7.1, R2 = 0.70). Late stage atherosclerotic plaques displayed the strongest increase in CNR, R1, ex vivo fibrin staining and gadolinium concentration (p < 0.05).ConclusionThis study demonstrated the feasibility of intraplaque and endothelial fibrin imaging using FTCA. Direct in vivo fibrin detection and quantification could be useful for characterization and staging of coronary and carotid atherosclerotic lesions, which may aid diagnosis and intervention.

► A fibrin-targeted contrast agent (FTCA) allows in vivo imaging of atherosclerosis. ► Late stage plaques show the strongest signal enhancement after FTCA administration. ► FTCA enables the assessment of response to therapy.