title: New quantification methods for carotid intra-plaque neovascularization using contrast-enhanced ultrasound.
abstract: As carotid intra-plaque neovascularization (IPN) is linked to progressive atherosclerotic disease and plaque vulnerability, its accurate quantification might allow early detection of plaque vulnerability. We therefore developed several new quantitative methods for analyzing IPN perfusion and structure. From our analyses, we derived six quantitative parameters-IPN surface area (IPNSA), IPN surface ratio (IPNSR), plaque mean intensity, plaque-to-lumen enhancement ratio, mean plaque contrast percentage and number of micro-vessels (MVN)-and compared these with visual grading of IPN by two independent physicians. A total of 45 carotid arteries with symptomatic stenosis in 23 patients were analyzed. IPNSA (correlation r = 0.719), IPNSR (r = 0.538) and MVN (r = 0.484) were found to be significantly correlated with visual scoring (p < 0.01). IPNSA was the best match to visual scoring. These results indicate that IPNSA, IPNSR and MVN may have the potential to replace qualitative visual scoring and to measure the degree of carotid IPN.
authors.affiliation: Department of Biomedical Engineering, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Zeynettin
authors.initials: Z
authors.lastname: Akkus
authors.forename: Assaf
authors.initials: A
authors.lastname: Hoogi
authors.forename: Guillaume
authors.initials: G
authors.lastname: Renaud
authors.forename: Stijn C H
authors.initials: SC
authors.lastname: van den Oord
authors.forename: Gerrit L
authors.initials: GL
authors.lastname: Ten Kate
authors.forename: Arend F L
authors.initials: AF
authors.lastname: Schinkel
authors.forename: Dan
authors.initials: D
authors.lastname: Adam
authors.forename: Nico
authors.initials: N
authors.lastname: de Jong
authors.forename: Antonius F W
authors.initials: AF
authors.lastname: van der Steen
authors.forename: Johan G
authors.initials: JG
authors.lastname: Bosch
mesh_terms: D000465:Algorithms; D016893:Carotid Stenosis / Q000150:complications* / Q000000981:diagnostic imaging*; D003287:Contrast Media; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging* / Q000209:etiology*; D015588:Observer Variation; D010363:Pattern Recognition, Automated / Q000379:methods; D010743:Phospholipids; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013459:Sulfur Hexafluoride; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride
keywords: Carotid plaque; Contrast agents; Contrast-enhanced ultrasound; Microbubbles; Microvessels; Plaque neovascularization; Quantification; Vasa vasorum