Quantitative Virtual Histology for In Vivo Evaluation of Human Atherosclerosis—A Plaque Biomechanics-Based Novel Image Analysis Algorithm: Validation and Applications to Atherosclerosis Research

Abstract Progress in biophysical modeling has recently identified several key plaque morphology features that play an important mechanistic role in plaque rupture, leading to often devastating clinical symptoms of the organ ischemia (stroke—in case of carotid artery atherosclerosis or myocardial infarction—in coronary atherosclerosis). Importantly, identification of these biophysics-relevant plaque features has been so far based on conventional (ex vivo) histological analyses while histological tissue processing affects both biological and biophysical characteristics of the atherosclerotic plaque components. Therefore, accurate (in situ), precise quantification of the key players that determine plaque biophysics and rupture risk is fundamental for increased precision of modeling in relation to better understanding the biologic processes and enhancing risk stratification.