Evidence map›Paper›PMID 41772159›Full record

Observational studyClinical neuroradiology2026

Evaluation of Carotid Plaque Vulnerability Using Dual-energy Computed Tomography Angiography: a Prospective Observational Study.

Sakyo Hirai, Takuya Watanabe, Satoru Takahashi, Hiroto Hada, Hikaru Wakabayashi, Mariko Ishikawa, Kosuke Umeda, Hirotaka Sagawa, Shoko Fujii, Kyohei Fujita and 2 more

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Clinical neuroradiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Sakyo HiraiDepartment of Endovascular Surgery, Institute of Science Tokyo, Tokyo, Japan. hirai.evs@tmd.ac.jp.
Takuya WatanabeDepartment of Radiology Center, Institute of Science Tokyo Hospital, Tokyo, Japan.
Satoru TakahashiDepartment of Endovascular Surgery, Institute of Science Tokyo, Tokyo, Japan.
Hiroto HadaDepartment of Radiology Center, Institute of Science Tokyo Hospital, Tokyo, Japan.
Hikaru WakabayashiDepartment of Endovascular Surgery, Institute of Science Tokyo, Tokyo, Japan.
Mariko IshikawaDepartment of Endovascular Surgery, Institute of Science Tokyo, Tokyo, Japan.
Kosuke UmedaDepartment of Endovascular Surgery, Institute of Science Tokyo, Tokyo, Japan.
Hirotaka SagawaDepartment of Endovascular Surgery, Institute of Science Tokyo, Tokyo, Japan.
Shoko FujiiDepartment of Endovascular Surgery, Institute of Science Tokyo, Tokyo, Japan.
Kyohei FujitaDepartment of Endovascular Surgery, Institute of Science Tokyo, Tokyo, Japan.
Jun OyamaDepartment of Diagnostic Radiology, Institute of Science Tokyo, Tokyo, Japan.
Kazutaka SumitaDepartment of Diagnostic Radiology, Institute of Science Tokyo, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study aimed to assess the utility of dual-energy computed tomography (DECT) for evaluating carotid plaque vulnerability.

methodsThis prospective observational study included consecutive patients who underwent DECT for preoperative evaluation of carotid plaques before elective carotid artery stenting between June 2023 and May 2025. DECT parameters-including effective atomic number (Z), electron density (Rho), virtual non-contrast CT value (VNC), fat fraction (FF), and iodine concentration (IC)-were measured. Relative signal intensity (rSI) was calculated on T1-weighted magnetic resonance images as the ratio of plaque to adjacent sternocleidomastoid muscle signal.

resultsA total of 46 carotid plaques, asymptomatic (n = 27) and symptomatic (n = 19), were analyzed. Both Rho and VNC were significantly lower in symptomatic compared to asymptomatic lesions (Rho, 29.6 [IQR, 26.5-33.6] vs 37.4 [IQR, 30.4-42.7], p < 0.05; VNC, 25.0 [IQR, 19.5-30.9] vs 31.2 [IQR, 21.9-41.4], p < 0.05), and FF was significantly higher in symptomatic compared to asymptomatic ones (21.5 [IQR, 17.4-23.3] vs 15.1 [IQR, 11.6-20.1], p < 0.05). No significant correlation was observed between the rSI and any of the DECT parameters. Multivariate logistic regression analysis showed that FF was significantly associated with symptomatic lesions in a model including rSI and VNC (OR, 1.39 [95% CI, 1.03-1.99], p < 0.05). Receiver operating characteristic analysis showed that adding FF to rSI improved discrimination of symptomatic plaques compared with rSI alone (AUC, 0.792 vs 0.560, p < 0.05).

conclusionIn this exploratory study, DECT-derived FF was associated with symptomatic carotid plaques and may provide complementary information beyond MRI-based plaque assessment in patients with moderate-to-severe carotid artery stenosis.

Indexed as

Carotid StenosisComputed Tomography AngiographyPlaque, AtheroscleroticAgedFemaleHumansMaleMiddle AgedProspective StudiesRadiography, Dual-Energy Scanned ProjectionStentsCarotid artery stenosisDual energy computed tomographyFat fractionMagnetic resonance imagingPlaque vulnerability

Identifiers

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.