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Atherosclerosis. 2016 May;248:230-7. doi: 10.1016/j.atherosclerosis.2016.03.002. Epub 2016 Mar 15.

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

Author information

1
Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), 3 Melchor Fernández Almagro St, 28029 Madrid, Spain; Hospital Universitario HM Montepríncipe, 25 Montepríncipe Ave, 28660 Boadilla del Monte, Spain. Electronic address: beatriz.lopez@cnic.es.
2
Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), 3 Melchor Fernández Almagro St, 28029 Madrid, Spain; Hospital Universitario HM Montepríncipe, 25 Montepríncipe Ave, 28660 Boadilla del Monte, Spain. Electronic address: leticia.fernandez@cnic.es.
3
Philips Healthcare, 1 María de Portugal St, 28050 Madrid, Spain. Electronic address: javier.sanchez.gonzalez@philips.com.
4
Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), 3 Melchor Fernández Almagro St, 28029 Madrid, Spain; Hospital Universitario Clínico San Carlos, Profesor Martín Lagos St, 28040 Madrid, Spain. Electronic address: jeanpaul.vilchez@gmail.com.
5
Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), 3 Melchor Fernández Almagro St, 28029 Madrid, Spain; Hospital Universitario Clínico San Carlos, Profesor Martín Lagos St, 28040 Madrid, Spain. Electronic address: albertocecconi@hotmail.com.
6
Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), 3 Melchor Fernández Almagro St, 28029 Madrid, Spain. Electronic address: jesus.mateo@cnic.es.
7
Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), 3 Melchor Fernández Almagro St, 28029 Madrid, Spain; Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, MA, 02111 Boston, USA. Electronic address: jlpenalvo@cnic.es.
8
Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), 3 Melchor Fernández Almagro St, 28029 Madrid, Spain. Electronic address: belen.oliva@cnic.es.
9
Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), 3 Melchor Fernández Almagro St, 28029 Madrid, Spain. Electronic address: josemanuel.garcia@externo.cnic.es.
10
Philips Healthcare, 1 María de Portugal St, 28050 Madrid, Spain. Electronic address: steve.kauffman@philips.com.
11
Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), 3 Melchor Fernández Almagro St, 28029 Madrid, Spain; Hospital Universitario La Princesa, 62 Diego Leon St, 28006 Madrid, Spain. Electronic address: ljborreguero@gmail.com.
12
Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), 3 Melchor Fernández Almagro St, 28029 Madrid, Spain; Universidad Complutense de Madrid and Ciber de Enfermedades Respiratorias (CIBERES), 2 Séneca Ave, 28040 Madrid, Spain. Electronic address: ruizcabe@cnic.es.
13
Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), 3 Melchor Fernández Almagro St, 28029 Madrid, Spain; Hospital Universitario Clínico San Carlos, Profesor Martín Lagos St, 28040 Madrid, Spain. Electronic address: antonioignacio.fernandez@cnic.es.
14
Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), 3 Melchor Fernández Almagro St, 28029 Madrid, Spain; IIS-Fundación Jiménez Díaz Hospital, 2 Reyes Católicos Ave, 28040 Madrid, Spain. Electronic address: bibanez@cnic.es.
15
Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), 3 Melchor Fernández Almagro St, 28029 Madrid, Spain; Mount Sinai Heart, Icahn School of Medicine, 1 Gustave L. Levy Place, Box 1030, New York City, NY 10029, USA. Electronic address: valentin.fuster@mountsinai.org.

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.

KEYWORDS:

Accuracy; Atherosclerotic plaque; Gold-standard; Plaque volume; Three-dimensional; Vascular ultrasound

[Indexed for MEDLINE]

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