Niranjan Balu1, Daniel S. Hippe1, Jie Sun1, Dongxiang Xu1, Thomas Hatsukami2, Chun Yuan1
1Radiology, University of Washington, Seattle, WA, United States; 2Surgery, University of Washington, Seattle, WA, United States
The size of the lipid-rich necrotic core (LRNC) in atherosclerotic plaque is an early indicator of efficacy in lipid lowering therapy. Clinical trials using LRNC as the primary endpoint require highly specific screening for subjects with LRNC in order to be cost-effective. We describe the first multicenter MRI study using LRNC as the primary study endpoint with a tiered ultrasound-MRI screening. A probabilistic model derived using sensitivity and specificity of maximum wall thickness (maxWT) in detecting subjects with LRNC shows that total imaging costs can be reduced by 10% while increasing specificity by adding maxWT to the tiered ultrasound-MRI screening.