Carotid Plaque Characteristics Predict Progression of White Matter Hyperintensities: A Prospective PET/MR Imaging Study

Motivation: The specific features of carotid plaques that contribute to the progression of white matter hyperintensities (WMH) in patients with carotid artery stenosis remain unclear. Goal(s): To identify which carotid plaque characteristics can predict the worsening of WMH grades over a one-year period. Approach: We conducted a prospective study with 134 patients undergoing baseline and one-year follow-up PET/MR imaging. We evaluated carotid plaque and vessel wall indexes , WMH volumes and grades were quantified, and multivariate regression analyses determined associations between plaque indicators and WMH progression. Results: High baseline PET uptake and the presence of AHA type VI plaques were independently associated with WMH progression. Impact: By identifying carotid plaque features that predict WMH progression, this study enables early identification of high-risk patients, guiding targeted interventions to prevent cerebral vessel disease progression and cognitive decline in those with carotid artery stenosis.