Multi-Planar, Multi-Contrast and Multi-Time Point Analysis Tool (MOCHA) for Intracranial Vessel Wall Characterization

Area of Science:

• Neuroimaging
• Cardiovascular Imaging
• Medical Image Analysis

Background:

• Three-dimensional (3D) intracranial vessel wall (IVW) magnetic resonance imaging (MRI) reliably detects intracranial atherosclerotic disease (ICAD).
• A streamlined workflow for IVW analysis is needed for qualitative and quantitative measurements.

Purpose of the Study:

• To develop and validate the MOCHA image analysis pipeline.
• To enable registration of multicontrast and multitime point 3D IVW data.
• To facilitate multiplanar review and quantitative plaque characterization.

Main Methods:

• Retrospective analysis of 11 ICAD subjects using 3.0T MRI (3D TOF, T1w, PDw FSE sequences).
• IVW images were preprocessed using the MOCHA pipeline.
• Plaque detection and quantification (length, areas, wall thickness, NWI, CE ratio) by experienced readers.
• Scan-rescan reproducibility assessed using percent agreement, Cohen's κ, ICC, and Bland-Altman analysis.

Main Results:

• High overall agreement (92.7%, κ=0.822) in plaque detection across 150 paired segments.
• Excellent scan-rescan reproducibility for all plaque morphologic and enhancement measurements (ICCs > 0.90, no bias).

Conclusions:

• The MOCHA pipeline demonstrates high scan-rescan reproducibility for identifying and quantifying intracranial atherosclerosis.
• MOCHA shows potential for characterizing plaque composition and monitoring disease progression in ICAD.