{Reference Type}: Journal Article
{Title}: A novel imaging biomarker for prediction of cerebrovascular ischemic events: Pericarotid fat density.
{Author}: Beşler MS;Karadenizli MB;Ökten RS;
{Journal}: Am J Emerg Med
{Volume}: 84
{Issue}: 0
{Year}: 2024 Aug 5
{Factor}: 4.093
{DOI}: 10.1016/j.ajem.2024.08.004
{Abstract}: <B>BACKGROUND: </B>To investigate the relationship between pericarotid fat density measured in carotid CTA and vulnerable carotid plaque.<BR><B>METHODS: </B>This retrospective study included 374 participants who underwent carotid CTA between June 1, 2021, and December 1, 2021 (234 males, median age 68 years [interquartile range: 61-75]). Two groups, symptomatic and asymptomatic, were defined based on either diffusion-weighted MRI or a clinical history of acute ischemia or TIA within 6 months before or after CTA. The relationship between pericarotid fat density and cerebrovascular ischemic events was assessed using receiver operating characteristic analysis and binary logistic regression analysis.<BR><B>RESULTS: </B>In the symptomatic group (n = 135), mean pericarotid fat density (-63.3 ± 21.7 vs. -81.7 ± 16.9 HU, respectively; p < 0.001) and median maximum plaque thickness (4 [interquartile range: 3-6] vs. 3.7 [interquartile range: 2.6-4.7] mm, respectively; p = 0.002) were higher, while plaque density (42.1 ± 19.6 vs. 50.6 ± 20.4 HU, respectively; p = 0.001) was lower compared to the asymptomatic group. Pericarotid fat density (OR: 1.038, 95% CI: 1.023-1.053, p < 0.001) was identified as an independent predictor for symptomatic patients. The optimal cut-off value for pericarotid fat density predicting symptomatic patients was estimated as -74 HU (area under the curve: 0.753, 95% CI:0.699-0.808, p < 0.001). Inter-reader agreement for pericarotid fat density was found to be almost perfect (intraclass correlation coefficient: 0.818, 95% CI: 0.770-0.856, p < 0.001).<BR><B>CONCLUSIONS: </B>Pericarotid fat density may serve as an imaging biomarker in predicting acute cerebrovascular ischemic events.