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Preliminary scanning of healthy (unlesioned) murine femoral arteries (n = 5) demonstrated that transmission imaging did not provide useful images. This was a consequence of the cleared arteries becoming too transparent (rather than too opaque) for transmission imaging.However, this is beneficial for emission imaging as there is no absorbance/scattering of the emitted signal . In contrast, femoral arteries autofluoresce strongly in the emission channel, with the greatest signal following excitation at 405–445 nm (consistent with a 410 nm excitation peak for elastin14). 2-dimensional slices reconstructed from these images clearly distinguished the media from the lumen and adventitia and lumen.
In murine femoral arteries harvested 28 days after wire- (n = 6) or ligation- (n = 5) induced injury neointimal thickening was evident in non-tomographic emission projections (Figure 3A). In reconstructed 2-dimensional slices, concentric neointimal lesions could be distinguished from the media by their weaker emission (Figure 3B and Figure S1).
OPT emission images of whole mount samples of the aortic arch and its major branches from atherosclerotic mice (n = 8) identified lesions with the anticipated anatomical distribution (i.e., in the lesser curvature of the aortic arch, the brachiocephalic artery, and the origins of the left carotid and left subclavian arteries (Figure 4A). Cross-sectional images indicated that these were typically eccentric lesions and were readily distinguished from the media and lumen (Figure 4B, Figures S2 and S3).
Processing arteries for histological analysis following OPT confirmed the non-destructive nature of OPT, with sections successfully stained using histological (United States Trichrome, Picrosirius red) and immunohistochemical (α-SMA, Mac-2) techniques (Figures 3C and 4C).
Measurement of lesion size using OPT has been shown to be consistent with measurements obtained using image analysis of histological sections taken from the same artery11.
Planimetric measurements of lesion area obtained by OPT and histology correlated closely by linear regression for wire- (R2 = 0.92) and ligation-induced (R2 = 0.89) neointimal lesions and atherosclerotic plaques (R2 = 0.85). An important benefit of OPT is its ability to enable 3-dimensional analysis. By developing volumetric quantification of lesions with this technique, we were able to record lesion volumes in wire- (0.1100 ± 0.0091 mm3; n = 6) and ligation-injured femoral arteries (0.0200 ± 0.0089 mm3; n = 5) and also in atherosclerotic brachiocephalic arteries (0.180 ± 0.018 mm3; n = 8). Measurements were highly reproducible (coefficients of variation 5.4%, 11.4% and 4.8%, respectively, n = 4) for all types of lesion. Neointimal lesions in wire-injured vessels were larger (p <0.0001) than those produced by ligation, consistent with the greater degree of damage inflicted by the former.
The data generated could also be expressed as lesion profiles (Figure 5) and rendered for dynamic, qualitative evaluation (see Figures S1-S3). This approach clearly demonstrated the extent of lesion formation in response to different injury procedures and highlighted the uneven distribution of lesion formation in injured vessels.

Figure 1: Methods for initiating lesion formation in murine femoral artery. (A) Retrograde insertion of an angioplasty guidewire into the femoral artery, by means of an arteriotomy in the popliteal artery stimulates lesion formation in response to stretch injury and removal of the endothelium. Blood flow is re-established over the injured section of vessel. (B) Neointimal proliferation in the absence of intraluminal stretch, denudation or interruption to blood flow can be induced by ligating either the femoral or the popliteal artery immediately distal to the femoral artery bifurcation. (C) A more severe non-denuding injury/ proliferation response can be induced by ligating both the femoral and popliteal arteries across the branch point of the common femoral artery. This technique will also block blood flow in the distal portion of the femoral artery.

Figure 2: Characteristic deposition of atheroma in the mouse aortic arch. Atherosclerosis prone (Apolipopotein E deficient mice) fed a high cholesterol western diet for 12 weeks develop a characteristic pattern of lesion deposition in the aortic arch and its major branches. As demonstrated, lesions are visible (arrows), by gross inspection under a dissecting microscope, in the aortic arch, the brachiocephalic artery, and in the ostia of the left carotid artery and left subclavian artery.

Figure 3: Lesion formation following ligation of the left femoral artery. (A) Non-tomographic fluorescence emission images (inverted to increase clarity – dark regions correspond to stronger emission) allow identification of intimal thickening (red arrowheads). (B) Distinct vascular regions and the lumen can be distinguished in tomographic reconstructions. (C) Histological analysis (United States trichrome) emphasises the clear resemblance with images obtained using OPT. Scale bars in (A-C) are 200 mm. Adapted from Kirkby et al.11 Scale bars in (A-C) are 200 µm.

Figure 4: Imaging of atheroma in the aortic arch of atherosclerosis prone mice. (A) Atheroma (red arrowheads) is readily apparent in non-tomographic images (inverted so that darker regions indicate stronger emission, thus improving clarity) of the aortic arch, in sites predicted as atheroma-bearing by inspection under light microscopy (see Figure 2). (B) This pattern of distribution is confirmed in tomographic cross-sections. (C) Histological (United States trichrome) staining shows close similarity with tomographic sections, and immunohistochemistry using several different antibodies emphasises the complementary nature of OPT with traditional approaches to lesion analysis. Scale bars in (A–B) are 1 mm; Scale bar in (C) is 250 µm. RSA, right subclavian artery; RCA, right carotid artery; LCA, left carotid artery; LSA, left subclavian artery; BCA, brachiocephalic artery; AAo, ascending aorta; DAo, descending aorta. Adapted from Kirkby et al.11

Figure 5: Analysis of lesion and lumen profiles indicates varying extent of neointimal proliferation in response to different methods of arterial injury. Optical projection tomography allows lesion and lumen cross sectional measurements to be plotted against distance along the femoral artery. This clearly demonstrates that, compared with an uninjured artery (A), partial ligation (B) produces small, relatively discrete lesions, whereas total ligation (C) produces complete occlusion at the site of ligation but the lesion does not extend far along the artery. Intraluminal wire injury (D) produces a lesion that almost completely occludes the distal portion of the sample and extends along the entire length of the scanned section of artery. Adapted from Kirkby et al.11
Figure S1. Animated reconstruction of cross-sectional images obtained from a mouse femoral artery following ligation injury.This type of animated image is useful for both qualitative and quantitative analysis. As the animation moves from the proximal to the distal sections of the artery the gradual development of an occlusive neointima, discernible from the lumen and the media, is readily apparent. Side branches can be easily identified and there is evident luminal occlusion and outward remodelling of the artery as the lesion increases in size. Complete occlusion of the vessel occurs once the site of ligation is reached. Adapted from Kirkby et al.11
Figure S2. Animated reconstruction of cross-sectional images of an aortic arch from an atherosclerosis-prone mouse. The animation commences with cross-sections of the ascending (left – which appears first) and descending (right) aorta. Small lesions appear in the ascending aorta as the scan moves in the direction of the aortic arch. The images then move through the arch to show the heavily lesioned ostia of the brachiocephalic (left), left carotid (middle) and left subclavian (right) arteries. As the scan moves distally along these branches the lesions gradually reduce and disappear, first in the subclavian artery, then in the carotid and finally in the brachiocephalic artery. Interestingly, the lesion in the brachiocephalic artery moves onto the flow divider as this vessel divides into the right carotid and right subclavian arteries. Adapted from Kirkby et al.11
Figure S3. Animated, volume-rendered image of an aortic arch from an atherosclerosis-prone mouse. Optical projection tomography allows generation of 3-dimensional images, in this case demonstrating lesion distribution in the aortic arch of an apolipoprotein E deficient mouse. (A) Atheroma is present in the expected sites (throughout the brachiocephalic artery, in the ostia of the left carotid and subclavian arteries and in the lesser curvature of the aortic arch). (B) Segmentation and rendering of lesion (shown in red) bearing cross-sections emphasises the distribution of plaques when superimposed on the original image. Adapted from Kirkby et al.11