title: Improved correlation between carotid and coronary atherosclerosis SYNTAX score using automated ultrasound carotid bulb plaque IMT measurement.
abstract: Described here is a detailed novel pilot study on whether the SYNTAX (Synergy between percutaneous coronary intervention with TAXUS and cardiac surgery) score, a measure of coronary artery disease complexity, could be better predicted with carotid intima-media thickness (cIMT) measures using automated IMT all along the common carotid and bulb plaque compared with manual IMT determined by sonographers. Three hundred seventy consecutive patients who underwent carotid ultrasound and coronary angiography were analyzed. SYNTAX score was determined from coronary angiograms by two experienced interventional cardiologists. Unlike most methods of cIMT measurement commonly used by sonographers, our method involves a computerized automated cIMT measurement all along the carotid artery that includes the bulb region and the region proximal to the bulb (under the class of AtheroEdge systems from AtheroPoint, Roseville, CA, USA). In this study, the correlation between automated cIMT that includes bulb plaque and SYNTAX score was found to be 0.467 (p < 0.0001), compared with 0.391 (p < 0.0001) for the correlation between the sonographer's IMT reading and SYNTAX score. The correlation between the automated cIMT and the sonographer's IMT was 0.882. When compared against the radiologist's manual tracings, automated cIMT system performance had a lumen-intima error of 0.007818 ± 0.0071 mm, media-adventitia error of 0.0179 ± 0.0125 mm and automated cIMT error of 0.0099 ± 0.00988 mm. The precision of automated cIMT against the manual radiologist's reading was 98.86%. This current automated algorithm revealed a significantly stronger correlation between cIMT and coronary SYNTAX score as compared with the sonographer's cIMT measurements with multiple cardiovascular risk factors. We benchmarked our correlation between the automated cIMT that includes bulb plaque and SYNTAX score against a previously published (Ikeda et al. 2013) AtheroEdgeLink (AtheroPoint) correlation between the automated cIMT that does not include bulb plaque and SYNTAX score and had an improvement of 44.58%. By sampling cIMT in the bulb region, the automated cIMT technique improves the degree of correlation between coronary artery disease lesion complexity and carotid atherosclerosis characteristics.
authors: Division of Cardiovascular Medicine, National Centre for Global Health and Medicine (NCGM), Tokyo, Japan.
authors: Nobutaka
authors: N
authors: Ikeda
authors: Department of Radiology, Brain and Mind Research Institute, Weill Cornell Medical College, New York, New York, USA.
authors: Ajay
authors: A
authors: Gupta
authors: Point of Care Devices, Global Biomedical Technologies, Inc., Roseville, California, USA.
authors: Nilanjan
authors: N
authors: Dey
authors: CorVasc Vascular Laboratory, Indianapolis, Indiana, USA.
authors: Soumyo
authors: S
authors: Bose
authors: Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan.
authors: Shoaib
authors: S
authors: Shafique
authors: Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan.
authors: Tadashi
authors: T
authors: Arak
authors: IMIM-Hospital del Mar, Barcelona, Spain.
authors: Elisa Cuadrado
authors: EC
authors: Godia
authors: Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.) di Cagliari-Polo di Monserrato, Università di Cagliari, Cagliari, Italy.
authors: Luca
authors: L
authors: Saba
authors: University of California at Davis Vascular Center, Davis, California, USA.
authors: John R
authors: JR
authors: Laird
authors: Vascular Screening and Diagnostic Centre, London, UK; Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus.
authors: Andrew
authors: A
authors: Nicolaides
authors: Point of Care Devices, Global Biomedical Technologies, Inc., Roseville, California, USA; Diagnostic and Monitoring Division, AtheroPoint™ LLC, Roseville, California, USA; Electrical Engineering Department (Aff.), Idaho State University, Pocatello, Idaho, USA. Electronic address: jasjit.suri@atheropoint.com.
authors: Jasjit S
authors: JS
authors: Suri
mesh_terms: D000368:Aged; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging*; D059168:Carotid Intima-Media Thickness; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D010363:Pattern Recognition, Automated / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013223:Statistics as Topic
keywords: Angiogram; Automated carotid intima–media thickness; B-mode; Bulb plaque; Carotid artery; Coronary artery disease; Correlation; SYNTAX score; Ultrasound