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Feasibility and Applicability of Wireless Handheld Ultrasound Measurement of Carotid Intima-Media Thickness in
Albert Youngwoo Jang1,2, Jeongwon Ryu2,3,4, Pyung Chun Oh1,2
1Department of Cardiovascular Medicine, Gachon University Gil Medical Center, Incheon, Korea.
Insights
A wireless handheld ultrasound device accurately measures carotid intima-media thickness (CIMT) in symptomatic patients. This tool enhances coronary artery disease (CAD) risk prediction when combined with clinical factors and plaque information.
Area of Science:
- Cardiovascular Medicine
- Medical Imaging Technology
- Diagnostic Ultrasound
Background:
- Routine screening for carotid intima-media thickness (CIMT) and cardiovascular (CV) disease is often costly and inefficient for detecting coronary artery disease (CAD) in asymptomatic individuals.
- The cost-effectiveness of CIMT screening is a significant concern, necessitating innovative and economical diagnostic approaches.
Purpose of the Study:
- To investigate the feasibility and diagnostic performance of an economic wireless handheld ultrasound (WHUS) device for CIMT measurement in symptomatic patients.
- To evaluate the WHUS device's accuracy and repeatability compared to standard ultrasound methods for CIMT assessment.
Main Methods:
- A total of 100 consecutive patients with cardiac symptoms underwent CIMT measurement using the WHUS device.
- Coronary angiography was performed in 75 patients indicated for the procedure to assess for CAD.
- The WHUS device's measurements were compared against a standard ultrasound device for agreement and interobserver repeatability.
Main Results:
- The WHUS device demonstrated excellent agreement (ICC=0.960) and interobserver repeatability (ICC>0.9) for maximal CIMT (max-CIMT) measurements compared to standard ultrasound.
- Adding max-CIMT and plaque information (plaque≥2) to traditional clinical CV risk factors improved CAD predictive power (AUC: 0.838 vs. 0.769).
- The WHUS device showed a cutoff value of 1.10 mm for CAD prediction (AUC: 0.725), with high sensitivity (0.98) and lower specificity (0.27).
Conclusions:
- Wireless handheld ultrasound (WHUS) devices provide accurate and repeatable CIMT measurements comparable to standard ultrasound.
- Combined max-CIMT and plaque data from WHUS enhance the predictive capability for identifying high-risk CAD patients when integrated with clinical risk factors.
Purpose:
Routine screening for carotid intima-media thickness (CIMT) and cardiovascular (CV) disease in asymptomatic patients has been criticized for the high costs and large number of patients required for detecting one patient with coronary artery disease (CAD). In order to overcome the low cost-effectiveness thereof, we investigated the feasibility of an economic wireless handheld ultrasound (WHUS) device for CIMT measurement in symptomatic patients.
Materials And Methods:
A total of 100 consecutive patients with cardiac symptoms were enrolled. CIMT was measured in all patients. Coronary angiography was performed in 75 patients indicated for the exam.
Results:
The mean of maximal CIMT measured from left/right common carotid artery and bulb (max-CIMT) by the WHUS device showed excellent agreement [intraclass correlation coefficient (ICC)=0.960] with a standard ultrasound device and great interobserver repeatability (ICC>0.9 between all observers). Receiver operating characteristic curve analysis showed that the predictive power for CAD was improved when max-CIMT and plaque information (plaque≥2) was added [area under the curve (AUC): 0.838] to the traditional clinical CV risk factors (AUC: 0.769). The cutoff values for CAD prediction with the standard device and the WHUS device were 1.05 mm (AUC: 0.807, sensitivity: 0.78, specificity: 0.53) and 1.10 mm (AUC: 0.725, sensitivity: 0.98, specificity: 0.27), respectively.
Conclusion:
max-CIMT measured by a WHUS device showed excellent agreement and repeatability, compared with standard ultrasound. Combined max-CIMT and plaque information added predictive power to the traditional clinical CV risk factors in detecting high-risk CAD patients.
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