Accurate quantification of atherosclerotic plaque volume by 3D vascular ultrasound using the volumetric linear array method

Beatriz Lopez-Melgar, Leticia Fernandez-Friera, Javier Sanchez-Gonzalez, Jean Paul Vilchez, Alberto Cecconi, Jesus Mateo, Jose L. Penalvo, Belen Oliva, Jose M. Garcia-Ruiz, Steve Kauffman, Luis Jesus Jimenez-Borreguero, Jesus Ruiz-Cabello, Antonio Fernandez-Ortiz, Borja Ibanez, Valentin Fuster

Research output: Contribution to journalA1: Web of Science-article

Abstract

Introduction: Direct quantification of atherosclerotic plaque volume by three-dimensional vascular ultrasound (3DVUS) is more reproducible than 2DUS-based three-dimensional (2D/3D) techniques that generate pseudo-3D volumes from summed 2D plaque areas; however, its accuracy has not been reported. We aimed to determine 3DVUS accuracy for plaque volume measurement with special emphasis on small plaques (a hallmark of early atherosclerosis).

Methods: The in vitro study consisted of nine phantoms of different volumes (small and medium-large) embedded at variable distances from the surface (superficial vs. >5 cm-depth) and comparison of 3DVUS data generated using a novel volumetric-linear array method with the real phantom volumes. The in vivo study was undertaken in a rabbit model of atherosclerosis in which 3DVUS and 2D/3D volume measurements were correlated against gold-standard histological measurements.

Results: In the in vitro setting, there was a strong correlation between 3DVUS measures and real phantom volume both for small (3.0-64.5 mm(3) size) and medium-large (91.1-965.5 mm(3) size) phantoms embedded superficially, with intraclass correlation coefficients (ICC) of 0.99 and 0.98, respectively; conversely, when phantoms were placed at >5 cm, the correlation was only moderate (ICC = 0.67). In the in vivo setting there was strong correlation between 3DVUS-measured plaque volumes and the histological gold-standard (ICC = 0.99 [4.02-92.5 mm(3) size]). Conversely, the correlation between 2D/3D values and the histological gold standard (sum of plaque areas) was weaker (ICC = 0.87 [49-520 mm(2) size]), with large dispersion of the differences between measurements in Bland-Altman plots (mean error, 79.2 mm(2)).

Conclusions: 3DVUS using the volumetric-linear array method accurately measures plaque volumes, including those of small plaques. Measurements are more accurate for superficial arterial territories than for deep territories. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

Original languageEnglish
JournalAtherosclerosis
Volume248
Pages (from-to)230-237
Number of pages8
ISSN0021-9150
DOIs
Publication statusPublished - 2016

Keywords

  • Three-dimensional
  • Vascular ultrasound
  • Atherosclerotic plaque
  • Plaque volume
  • Accuracy
  • Gold-standard
  • CORONARY-ARTERY-DISEASE
  • CAROTID PLAQUE
  • 3-DIMENSIONAL ULTRASOUND
  • SUBCLINICAL ATHEROSCLEROSIS
  • EXPERIMENTAL-MODEL
  • REPRODUCIBILITY
  • PROGRESSION
  • PREVALENCE
  • MORPHOLOGY
  • FIXATION

Cite this