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In recent years however, synchrotron radiation-based micro-computed tomography (SR\u03bcCT) has become a tool for extending the imaging of two-dimensional thin sections into three-dimensional imaging of tissue blocks, enabling so-called virtual histology with arbitrary clipping planes, volumetric rendering and automatic segmentation. In this study, we present a thorough characterization of human carotid plaques after endarterectomy of patients with stroke or transient ischemic attack (TIA), investigating several different pathologic structures using both SR\u03bcCT and histology. Phase-contrast SR\u03bcCT was performed with two different magnifications (voxel sizes 6.5 \u03bcm and 0.65 \u03bcm, respectively), and histology was performed with multiple different stainings (Alpha-actin, Glycophorin A, von Kossa, Movat, CD68). The 0.65 \u03bcm high-resolution SR\u03bcCT was performed on selected areas with plaque typical relevant morphology, identified on the 6.5 \u03bcm low-resolution SR\u03bcCT. The tomography datasets were reconstructed with additional 3D volume rendering and compared to histology. In total, nine different regions with typical pathologic structures were identified and imaged with high-resolution SR\u03bcCT. The results show many characteristics typical for advanced atherosclerotic plaques, clinically relevant, namely ruptures with thrombosis, neo-vascularization, inflammatory infiltrates in shoulder regions, lipid rich necrotic cores (LRNC), thin fibrous cap, calcifications, lumen irregularities, and changes in vessel wall structures such as the internal elastic membrane. This method\u2019s non-destructive nature renders details of micro-structures with an excellent visual likeness to histology, with the additional strength of multiplanar and 3D visualization and the possibility of multiple re-scans.<\/jats:p>","DOI":"10.1371\/journal.pone.0265598","type":"journal-article","created":{"date-parts":[[2022,4,26]],"date-time":"2022-04-26T17:58:07Z","timestamp":1650995887000},"page":"e0265598","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["Sub-micrometer morphology of human atherosclerotic plaque revealed by synchrotron radiation-based \u03bcCT\u2014A comparison with histology"],"prefix":"10.1371","volume":"17","author":[{"given":"My","family":"Truong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6632-402X","authenticated-orcid":true,"given":"Till","family":"Dreier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1896-381X","authenticated-orcid":true,"given":"Johan","family":"Wass\u00e9lius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Sundius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Persson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0833-4043","authenticated-orcid":true,"given":"Goran","family":"Lovric","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5537-8682","authenticated-orcid":true,"given":"Anne","family":"Bonnin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Goncalves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9109-7175","authenticated-orcid":true,"given":"Martin","family":"Bech","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,4,26]]},"reference":[{"issue":"3","key":"pone.0265598.ref001","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1161\/CIRCRESAHA.116.308413","article-title":"Global Burden of Stroke.","volume":"120","author":"VL Feigin","year":"2017","journal-title":"Circulation research"},{"issue":"1","key":"pone.0265598.ref002","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1038\/s41572-019-0106-z","article-title":"Atherosclerosis.","volume":"5","author":"P Libby","year":"2019","journal-title":"Nature Reviews Disease Primers"},{"issue":"2","key":"pone.0265598.ref003","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1056\/NEJM199901143400207","article-title":"Atherosclerosis\u2014an inflammatory disease","volume":"340","author":"R. 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