Comparison of Acoustic Radiation Force Impulse Imaging Derived Carotid Plaque Stiffness With Spatially Registered MRI Determined Composition

Doherty, Joshua R.; Dahl, Jeremy J.; Kranz, Peter G.; Husseini, Nada El; Chang, Hing‐Chiu; Chen, Nan‐kuei; Allen, Jason D.; Ham, Katherine L.; Trahey, Gregg E.

doi:10.1109/tmi.2015.2432797

Cited by 29 publications

(15 citation statements)

References 38 publications

(32 reference statements)

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“…To date, ARFI plaque characterization in clinical studies has been implemented with 6 MHz [26] and 9 MHz [27] tracking pulses, but 12 MHz sequences have yet to be tested in vivo . At such high frequencies, depth of penetration may be an issue, however 12 MHz B-mode is currently the upper limit that is utilized in the clinic for carotid imaging [39], suggesting this frequency may be relevant in an ARFI setting as well.…”

Section: Discussionmentioning

confidence: 99%

“…In ARFI, long-duration ultrasound pulses (~100 μs) are used to induce μm-order displacements in tissue to qualitatively infer tissue stiffness. The literature supporting the use of ARFI for vascular and atherosclerosis applications has been growing rapidly [17]–[27]. These studies suggest that ARFI can discriminate necrotic/lipid from fibrous/calcified regions, which appear as areas of relatively-high displacement and relatively-low displacement, respectively.…”

Section: Introductionmentioning

confidence: 99%

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On the Feasibility of Quantifying Fibrous Cap Thickness With Acoustic Radiation Force Impulse (ARFI) Ultrasound

Czernuszewicz

Gallippi

2016

IEEE Trans. Ultrason., Ferroelect., Freq. Contr.

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Acute cerebrovascular accidents are associated with the rupture of vulnerable atherosclerotic plaques in the carotid arteries. Fibrous cap thickness has been shown to be an important predictor of plaque rupture, but has been challenging to measure accurately with clinical noninvasive imaging modalities. The goals of this investigation were first, to evaluate the feasibility of using transcutaneous acoustic radiation force impulse (ARFI) ultrasound to quantify fibrous cap thickness and second, to optimize both imaging and motion tracking parameters to support such measurements. Fibrous caps with varying thickness (0.1 – 1.0 mm) were simulated using a simple layered geometry, and their mechanical response to an impulse of radiation force was solved using finite element method (FEM) modeling. Ultrasound tracking of FEM displacements was performed in Field II utilizing three center frequencies (6, 9, and 12 MHz) and eight motion tracking kernel lengths (0.5λ – 4λ). Additionally, fibrous cap thickness in two carotid plaques imaged in vivo was measured with ARFI and compared to matched histology. The results of this study demonstrate that 1) tracking pulse frequencies around 12 MHz are necessary to resolve caps around 0.2 mm, 2) large motion-tracking kernel sizes introduce bias into thickness measurements and overestimate the true cap thickness, and 3) color saturation settings on ARFI peak displacement images can impact thickness measurement accuracy substantially.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

On the Feasibility of Quantifying Fibrous Cap Thickness With Acoustic Radiation Force Impulse (ARFI) Ultrasound

Czernuszewicz

Gallippi

2016

IEEE Trans. Ultrason., Ferroelect., Freq. Contr.

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“…Vessel phantoms have also been utilized by some groups to develop strain algorithms (Hansen et al , 2014; Korukonda et al , 2013; Hasegawa and Kanai, 2008). Acoustic radiation force impulse imaging has been used (Czernuszewicz et al , 2015; Doherty et al , 2015) to estimate displacements in carotid plaque.…”

Section: Introductionmentioning

confidence: 99%

Quantification of carotid artery plaque stability with multiple region of interest based ultrasound strain indices and relationship with cognition

et al. 2017

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Vulnerability and instability in carotid artery plaque has been assessed based on strain variations using noninvasive ultrasound imaging. We previously demonstrated that carotid plaques with higher strain indices in a region of interest (ROI) correlated to patients with lower cognition, probably due to cerebrovascular emboli arising from these unstable plaques. This work attempts to characterize the strain distribution throughout the entire plaque region instead of being restricted to a single localized ROI. Multiple ROIs are selected within the entire plaque region, based on thresholds determined by the maximum and average strains in the entire plaque, enabling generation of additional relevant strain indices. Ultrasound strain imaging of carotid plaques, was performed on 60 human patients using an 18L6 transducer coupled to a Siemens Acuson S2000 system to acquire radiofrequency data over several cardiac cycles. Patients also underwent a battery of neuropsychological tests under a protocol based on National Institute of Neurological Disorders and Stroke and Canadian Stroke Network guidelines. Correlation of strain indices with composite cognitive index of executive function revealed a negative association relating high strain to poor cognition. Patients grouped into high and low cognition groups were then classified using these additional strain indices. One of our newer indices, namely the average L-1 norm with plaque (AL1NWP) presented with significantly improved correlation with executive function when compared to our previously reported maximum accumulated strain indices (MASI). An optimal combination of three of the new indices generated classifiers of patient cognition with an area under the curve (AUC) of 0.880, 0.921 and 0.905 for all (n=60), symptomatic (n=33) and asymptomatic patients (n=27) whereas classifiers using maximum accumulated strain indices alone provided AUC values of 0.817, 0.815 and 0.813 respectively.

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“…ARFI imaging displacements have also been used to characterize carotid plaques on five patients and 25 patients, respectively. ARFI is unable to differentiate calcium from normal loose matrix, and adjacent arterial tissue could limit the stiffness of lipidic regions measured …”

Section: Introductionmentioning

confidence: 99%

Lagrangian carotid strain imaging indices normalized to blood pressure for vulnerable plaque

Varghese

Meshram

Mitchell

et al. 2019

J of Clinical Ultrasound

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Objective Ultrasound Lagrangian carotid strain imaging (LCSI) utilizes physiological deformation caused by arterial pressure variations to generate strain tensor maps of the vessel walls and plaques. LCSI has been criticized for the lack of normalization of magnitude‐based strain indices to physiological stimuli, namely blood pressure. We evaluated the impact of normalization of magnitude‐based strain indices to blood pressure measured immediately after the acquisition of radiofrequency (RF) data loops for LCSI. Materials and Methods A complete clinical ultrasound examination along with RF data loops for LCSI was performed on 50 patients (30 males and 20 females) who presented with >60% carotid stenosis and were scheduled for carotid endarterectomy. Cognition was assessed using the 60‐minute neuropsychological test protocol. Results For axial strains correlation of maximum accumulated strain indices (MASI), cognition scores were −0.46 for non‐normalized and −0.45, −0.49, −0.37, and −0.48 for systolic, diastolic, pulse pressure, and mean arterial pressure normalized data, respectively. The corresponding area under the curve (AUC) values for classifiers designed using maximum likelihood estimation of a binormal distribution with a median‐split of the executive function cognition scores were 0.73, 0.70, 0.71, 0.70, and 0.71, respectively. Conclusions No significant differences in the AUC estimates were obtained between normalized and non‐normalized magnitude‐based strain indices.

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Comparison of Acoustic Radiation Force Impulse Imaging Derived Carotid Plaque Stiffness With Spatially Registered MRI Determined Composition

Cited by 29 publications

References 38 publications

On the Feasibility of Quantifying Fibrous Cap Thickness With Acoustic Radiation Force Impulse (ARFI) Ultrasound

On the Feasibility of Quantifying Fibrous Cap Thickness With Acoustic Radiation Force Impulse (ARFI) Ultrasound

Quantification of carotid artery plaque stability with multiple region of interest based ultrasound strain indices and relationship with cognition

Lagrangian carotid strain imaging indices normalized to blood pressure for vulnerable plaque

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