Determining carotid plaque vulnerability using ultrasound center frequency shifts
Tobias Erlöv1, Magnus Cinthio1, Andreas Edsfeldt2
1Department of Biomedical Engineering, Faculty of Engineering, Lund University, Sweden.
Insights
A new ultrasound method accurately identifies vulnerable atherosclerotic plaques by analyzing center frequency shift (CFS). This non-invasive technique aids in detecting high-risk carotid plaques, improving cardiovascular disease risk assessment.
Area of Science:
- Cardiovascular Imaging
- Biomedical Ultrasound
- Atherosclerosis Research
Background:
- Atherosclerotic cardiovascular disease is a major global health burden, often stemming from vulnerable plaque rupture.
- Current non-invasive methods for identifying high-risk plaques remain suboptimal.
- Accurate detection of vulnerable plaques is crucial for preventing cardiovascular events like stroke and myocardial infarction.
Purpose of the Study:
- To validate a novel non-invasive ultrasound technique for identifying high-risk carotid plaques.
- To assess the capability of center frequency shift (CFS) in characterizing plaque components related to vulnerability.
Main Methods:
- A new ultrasound method analyzing center frequency shift (CFS) in carotid plaques was evaluated.
- The method was tested ex vivo on plaque sections and in vivo on patients prior to plaque removal.
- Ultrasound data were correlated with histological findings of plaque components.
Main Results:
- CFS demonstrated a significant correlation with a histological plaque vulnerability index (r = -0.726, P = 1.7 × 10(-8)).
- Plaques with lower CFS exhibited characteristics of rupture-prone lesions, including larger lipid cores and more macrophages.
- The method achieved 78% accuracy in detecting highly vulnerable plaques, with 77% sensitivity and 78% specificity.
Conclusions:
- This study introduces the first ultrasound method utilizing CFS to characterize atherosclerotic plaque components influencing vulnerability.
- The validated non-invasive technique shows promise for improved identification of high-risk carotid plaques.
- This advancement could lead to better risk stratification and personalized treatment strategies for patients with atherosclerotic disease.
Background:
The leading cause of morbidity and mortality worldwide is atherosclerotic cardiovascular disease, most commonly caused by rupture of a high-risk plaque and subsequent thrombosis resulting in stroke, myocardial infarction or sudden death depending on the affected arterial territory. Accurate, non-invasive methods to identify such lesions known as vulnerable or high-risk plaques are currently sub-optimal. Our aim was to validate a new non-invasive ultrasound method to identify high-risk carotid plaques.
Methods:
We evaluated a new method based on the center frequency shift (CFS) of the ultrasound radio frequency data obtained from carotid plaques compared to a reference phantom. We evaluated the method both ex vivo, on 157 sections from 18 plaques, and in vivo, in 39 patients 1-day prior to carotid plaque removal, and correlated the data with histology.
Results:
The CFS correlated with a plaque vulnerability index based on histological areas stained for lipids, macrophages, hemorrhage, smooth muscle cells and collagen (r = -0.726, P = 1.7 × 10(-8)). Plaques with CFS below median had larger cores, more macrophages and were less rich in collagen in agreement with the definition of rupture-prone plaques. The accuracy to detect plaques with high vulnerability index was 78% (confidence interval (CI) 61-89%), with sensitivity 77% (CI 61-89%) and specificity 78% (CI 62-89%).
Conclusions:
Our method is the first to characterize atherosclerotic plaque components that affect plaque vulnerability using CFS.
Related Concept Videos
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:19Assessing Blood pressure using a doppler ultrasound
Pre-Procedural Guidelines for Doppler Ultrasound Blood Pressure Assessment:
Preparation of Equipment: