Attenuation Correction and Normalisation for Quantification of Contrast Enhancement in Ultrasound Images of Carotid Arteries

Cheung, Wing Keung; Gujral, Dorothy M.; Shah, Benoy N.; Chahal, Navtej; Cosgrove, David O.; Eckersley, Robert J.; Harrington, Kevin; Senior, Roxy; Nutting, Christopher M.; Tang, Meng‐Xing

doi:10.1016/j.ultrasmedbio.2015.02.010

Cited by 11 publications

(7 citation statements)

References 20 publications

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“…Subsequently, Cheung et al (2015) developed an automated attenuation correction and normalization algorithm to optimize the quantification of intraplaque microvessels. The algorithm was validated on phantoms containing contrast agent-filled vessels embedded in tissue-mimicking material with known attenuation characteristics.…”

Section: Quantification Of Ceusmentioning

confidence: 99%

Contrast-Enhanced Ultrasound to Assess Carotid Intraplaque Neovascularization

Schinkel

Bosch

Staub

et al. 2020

Ultrasound in Medicine & Biology

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Contrast-enhanced ultrasound (CEUS) is increasingly being used to identify patients with carotid plaques that are vulnerable to rupture, so-called vulnerable atherosclerotic plaques, by assessment of intraplaque neovascularization. A complete overview of the strengths and limitations of carotid CEUS is currently not available. The aim of this systematic review was to provide a complete overview of existing publications on the role of CEUS in assessment of carotid intraplaque neovascularization. The systematic review of the literature yielded 52 studies including a total of 4660 patients (mean age: 66 y, 71% male) who underwent CEUS for the assessment of intraplaque neovascularization. The majority of the patients (76%) were asymptomatic and had no history of transient ischemic attack (TIA) or stroke. The assessment of intraplaque neovascularization was mostly performed using a visual scoring system; several studies used timeÀintensity curves or dedicated quantification software to optimize analysis. In 17 studies CEUS was performed in patients before carotid surgery (endarterectomy), allowing a comparison of pre-operative CEUS findings with histologic analysis of the tissue sample that is removed from the carotid artery. In a total of 576 patients, the CEUS findings were compared with histopathological analysis of the plaque after surgery. In 16 of the 17 studies, contrast enhancement was found to correlate with the presence and degree of intraplaque neovascularization on histology. Plaques with a larger amount of contrast enhancement had significantly increased density of microvessels in the corresponding region on histology. In conclusion, CEUS is a readily available imaging modality for the assessment of patients with carotid atherosclerosis, providing information on atherosclerotic plaques, such as ulceration and intraplaque neovascularization, which may be clinically relevant. The ultimate clinical goal is the early identification of carotid atherosclerosis to start early preventive therapy and prevent clinical complications such as TIA and stroke.

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Section: Quantification Of Ceusmentioning

confidence: 99%

Contrast-Enhanced Ultrasound to Assess Carotid Intraplaque Neovascularization

Schinkel

Bosch

Staub

et al. 2020

Ultrasound in Medicine & Biology

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“…This microvascular flow setup could also be used for dynamic contrast-enhanced ultrasound modes to develop new imaging modalities, 39,40 new transducers 41 or new quantification methods. 42…”

Section: Discussionmentioning

confidence: 99%

A Novel Microflow Phantom Dedicated to Ultrasound Microvascular Measurements

et al. 2018

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Tumor microvascularization is a biomarker of response to antiangiogenic treatments and is accurately assessed by ultrasound imaging. Imaging modes used to visualize slow flows include Power Doppler imaging, dynamic contrast-enhanced ultrasonography, and more recently, microvascular Doppler. Flow phantoms are used to evaluate the performance of Doppler imaging techniques, but they do not have a steady flow and sufficiently small channels. We report a novel device for robust and stable microflow measurements and the study of the microvascularization. Based on microfluidics technology, the prototype features wall-less cylindrical channels of diameters ranging from as small as 147 up to 436 µm, cast in a soft silicone polymer and perfused via a microfluidic flow pressure controller. The device was assessed using flow rates from 49 to 146 µL/min, with less than 1% coefficient of variation over three minutes, corresponding to velocities of 6 to 142 mm/s. This enabled us to evaluate and confirm the reliability of the Superb Microvascular Imaging Doppler mode compared with the Power Doppler mode at these flow rates in the presence of vibrations mimicking physiological motion.

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“…Recently, Cheung et al (Cheung et al 2015) The DIP is simple and computationally efficient and can be implemented in real time, as it only involves simple mathematical operations. The quantification process is semi-automated, only requiring manual input for segmenting the plaques.…”

Section: Discussionmentioning

confidence: 99%

Differential Intensity Projection for Visualisation and Quantification of Plaque Neovascularisation in Contrast-Enhanced Ultrasound Images of Carotid Arteries

Cheung

Shah

Stanziola

et al. 2017

Ultrasound in Medicine & Biology

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Studies have reported that intraplaque neovascularisation (IPN) is closely correlated with plaque vulnerability. In this study, a new image processing approach, differential intensity projection (DIP), was developed to visualise and quantify IPN in contrast-enhanced non-linear ultrasound image sequences of carotid arteries. DIP used the difference between the local temporal maximum and the local temporal average signals to identify bubbles against tissue non-linear artefact and noise. The total absolute and relative areas occupied by bubbles within each plaque were calculated to quantify IPN. In vitro measurements on a laboratory phantom were made, followed by in vivo measurements in which 24 contrast-enhanced non-linear ultrasound image sequences of carotid arteries from 48 patients were selected and motion corrected. The results using DIP were compared with those obtained by maximum intensity projection (MIP) and visual assessment. The results indicated that DIP can significantly reduce non-linear propagation tissue artefacts and is much more specific in detecting bubble signals than MIP, being able to reveal microbubble signals that are buried in tissue artefacts in the corresponding MIP image. A good correlation was found between microvascular area (MVA) (r = 0.83, p < 0.001)/microvascular density (r = 0.77, p < 0.001) obtained using DIP and the corresponding expert visual grades, comparing favourably to r = 0.26 and 0.23 obtained using MIP on the same data. In conclusion, the proposed method exhibits great potential in quantification of IPN in contrast-enhanced ultrasound images of carotid arteries.

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Attenuation Correction and Normalisation for Quantification of Contrast Enhancement in Ultrasound Images of Carotid Arteries

Cited by 11 publications

References 20 publications

Contrast-Enhanced Ultrasound to Assess Carotid Intraplaque Neovascularization

Contrast-Enhanced Ultrasound to Assess Carotid Intraplaque Neovascularization

A Novel Microflow Phantom Dedicated to Ultrasound Microvascular Measurements

Differential Intensity Projection for Visualisation and Quantification of Plaque Neovascularisation in Contrast-Enhanced Ultrasound Images of Carotid Arteries

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