title: Association of ultrasonic texture and echodensity features between sides in patients with bilateral carotid atherosclerosis.
abstract: OBJECTIVE
  Our objective was to estimate the correlation of echodensity and textural features, using ultrasound and digital image analysis, between plaques in patients with bilateral carotid stenosis.
  
  
  METHODS
  Cross-sectional observational study.
  
  
  METHODS
  Patients undergoing carotid endarterectomy were recruited from Vascular Surgery at the Royal Victoria and Jewish General hospitals in Montreal, Canada. Bilateral pre-operative carotid ultrasound and digital image analysis was performed to extract echodensity and textural features using a commercially available Plaque Texture Analysis software (LifeQMedical Ltd). Principal component analysis (PCA) was performed. Partial correlation coefficients for PCA and individual imaging variables between surgical and contralateral plaques were calculated with adjustment for age, sex, contralateral stenosis, and statin use.
  
  
  RESULTS
  In the whole group (n = 104), the six identified PCA variables and 42/50 individual imaging variables were moderately correlated (r = .211-.641). Correlations between sides were increased in patients with ≥50% contralateral stenosis and symptomatic patients.
  
  
  CONCLUSIONS
  Textural and echodensity features of carotid plaques were similar between two sides in patients with bilateral stenosis, supporting the notion that plaque instability is determined by systemic factors. Patients with unstable features of one plaque should perhaps be monitored more closely or treated more aggressively for their contralateral stenosis, particularly if this is hemodynamically significant.
authors.affiliation: Department of Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
authors.forename: R J
authors.initials: RJ
authors.lastname: Doonan
authors.forename: A J
authors.initials: AJ
authors.lastname: Dawson
authors.forename: E
authors.initials: E
authors.lastname: Kyriacou
authors.forename: A N
authors.initials: AN
authors.lastname: Nicolaides
authors.forename: M M
authors.initials: MM
authors.lastname: Corriveau
authors.forename: O K
authors.initials: OK
authors.lastname: Steinmetz
authors.forename: K S
authors.initials: KS
authors.lastname: Mackenzie
authors.forename: D I
authors.initials: DI
authors.lastname: Obrand
authors.forename: M E
authors.initials: ME
authors.lastname: Daskalopoulos
authors.forename: S S
authors.initials: SS
authors.lastname: Daskalopoulou
mesh_terms: D000368:Aged; D000465:Algorithms; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D007091:Image Processing, Computer-Assisted; D008297:Male; D025341:Principal Component Analysis; D011792:Quebec; D015203:Reproducibility of Results; D012984:Software; D014463:Ultrasonography
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Bilateral carotid stenosis; Carotid plaque; Digital image analysis; Texture analysis; Ultrasound