202 research outputs found

    The Ultrasound Window Into Vascular Ageing: A Technology Review by the VascAgeNet COST Action

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    Arteriosclerosis; Ultrasound; Vascular ageingArteriosclerosi; Ecografia; Envelliment vascularArteriosclerosis; Ecografía; Envejecimiento vascularNon-invasive ultrasound (US) imaging enables the assessment of the properties of superficial blood vessels. Various modes can be used for vascular characteristics analysis, ranging from radiofrequency (RF) data, Doppler- and standard B/M-mode imaging, to more recent ultra-high frequency and ultrafast techniques. The aim of the present work was to provide an overview of the current state-of-the-art non-invasive US technologies and corresponding vascular ageing characteristics from a technological perspective. Following an introduction about the basic concepts of the US technique, the characteristics considered in this review are clustered into: 1) vessel wall structure; 2) dynamic elastic properties, and 3) reactive vessel properties. The overview shows that ultrasound is a versatile, non-invasive, and safe imaging technique that can be adopted for obtaining information about function, structure, and reactivity in superficial arteries. The most suitable setting for a specific application must be selected according to spatial and temporal resolution requirements. The usefulness of standardization in the validation process and performance metric adoption emerges. Computer-based techniques should always be preferred to manual measures, as long as the algorithms and learning procedures are transparent and well described, and the performance leads to better results. Identification of a minimal clinically important difference is a crucial point for drawing conclusions regarding robustness of the techniques and for the translation into practice of any biomarker.This article is based upon work from COST Action CA18216 VascAgeNet, supported by COST (European Cooperation in Science and Technology, www.cost.eu). A.G. has received funding from “La Caixa” Foundation (LCF/BQ/PR22/11920008). R.E.C is supported by the National Health and Medical Research Council of Australia (reference: 2009005) and by a National Heart Foundation Future Leader Fellowship (reference: 105636). J.A. acknowledges support from the British Heart Foundation [PG/15/104/31913], the Wellcome EPSRC Centre for Medical Engineering at King's College London [WT 203148/Z/16/Z], and the Cardiovascular MedTech Co-operative at Guy's and St Thomas' NHS Foundation Trust [MIC-2016-019]

    Wall shear stress measurement in carotid artery phantoms with variation in degree of stenosis using plane wave vector doppler

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    Wall shear stress (WSS) plays an important role in the formation, growth, and rupture of atherosclerotic plaques in arteries. This study measured WSS in diseased carotid artery phantoms with degrees of stenosis varying from 0 to 60% with both steady and pulsatile flow. Experiments were performed using in silico and real flow phantoms. Blood velocities were estimated using plane wave (PW) vector Doppler. Wall shear stress was then estimated from the velocity gradient near the wall multiplied by the viscosity of a blood-mimicking fluid. The estimated WSS using the in silico phantom agreed within 10% of the ground-truth values (root-mean-square error). The phantom experiment showed that the mean WSS and maximum WSS increased with the increasing degree of stenosis. The simulation and experiment results provide the necessary validation data to give confidence in WSS measurements in patients using the PW vector Doppler technique

    Carotid Artery Disease

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    This book will bring out the state of art of carotid stenosis in the basic and clinical approaches for better understanding of the mechanisms and useful therapies for these disease. We hope that would be a new current trend understanding new aspects regarding this scientific problematic involving not only anatomical, functional but also clinical questions

    Vascular Segmentation Algorithms for Generating 3D Atherosclerotic Measurements

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    Atherosclerosis manifests as plaques within large arteries of the body and remains as a leading cause of mortality and morbidity in the world. Major cardiovascular events may occur in patients without known preexisting symptoms, thus it is important to monitor progression and regression of the plaque burden in the arteries for evaluating patient\u27s response to therapy. In this dissertation, our main focus is quantification of plaque burden from the carotid and femoral arteries, which are major sites for plaque formation, and are straight forward to image noninvasively due to their superficial location. Recently, 3D measurements of plaque burden have shown to be more sensitive to the changes of plaque burden than one-/two-dimensional measurements. However, despite the advancements of 3D noninvasive imaging technology with rapid acquisition capabilities, and the high sensitivity of the 3D plaque measurements of plaque burden, they are still not widely used due to the inordinate amount of time and effort required to delineate artery walls plus plaque boundaries to obtain 3D measurements from the images. Therefore, the objective of this dissertation is developing novel semi-automated segmentation methods to alleviate measurement burden from the observer for segmentation of the outer wall and lumen boundaries from: (1) 3D carotid ultrasound (US) images, (2) 3D carotid black-blood magnetic resonance (MR) images, and (3) 3D femoral black-blood MR images. Segmentation of the carotid lumen and outer wall from 3DUS images is a challenging task due to low image contrast, for which no method has been previously reported. Initially, we developed a 2D slice-wise segmentation algorithm based on the level set method, which was then extended to 3D. The 3D algorithm required fewer user interactions than manual delineation and the 2D method. The algorithm reduced user time by ≈79% (1.72 vs. 8.3 min) compared to manual segmentation for generating 3D-based measurements with high accuracy (Dice similarity coefficient (DSC)\u3e90%). Secondly, we developed a novel 3D multi-region segmentation algorithm, which simultaneously delineates both the carotid lumen and outer wall surfaces from MR images by evolving two coupled surfaces using a convex max-flow-based technique. The algorithm required user interaction only on a single transverse slice of the 3D image for generating 3D surfaces of the lumen and outer wall. The algorithm was parallelized using graphics processing units (GPU) to increase computational speed, thus reducing user time by 93% (0.78 vs. 12 min) compared to manual segmentation. Moreover, the algorithm yielded high accuracy (DSC \u3e 90%) and high precision (intra-observer CV \u3c 5.6% and inter-observer CV \u3c 6.6%). Finally, we developed and validated an algorithm based on convex max-flow formulation to segment the femoral arteries that enforces a tubular shape prior and an inter-surface consistency of the outer wall and lumen to maintain a minimum separation distance between the two surfaces. The algorithm required the observer to choose only about 11 points on its medial axis of the artery to yield the 3D surfaces of the lumen and outer wall, which reduced the operator time by 97% (1.8 vs. 70-80 min) compared to manual segmentation. Furthermore, the proposed algorithm reported DSC greater than 85% and small intra-observer variability (CV ≈ 6.69%). In conclusion, the development of robust semi-automated algorithms for generating 3D measurements of plaque burden may accelerate translation of 3D measurements to clinical trials and subsequently to clinical care

    Ultrasound assessed carotid atherosclerosis in a general population : the Tromsø study

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    As a neurologist with a special interest in cerebrovascular diseases, and with several years of practice with ultrasound examinations of extra- and intracranial arteries, I have some times experienced patients in whom ultrasound revealed unexpected findings which surprised mc, and made me wonder about etiological relationships and clinical implications. Thus, ultrasound examinations of the carotid arteries in some very old people showed smooth vessels without visible atherosclerosis, whereas in some young people with low cardiovascular risk factor levels, I found pronounced atherosclerosis with stenotic or occluded carotid arteries. Similarly, I have wondered why many patients with high-degree carotid stenosis did not suffer from ipsilateral ischemic cerebral stroke, whereas others who had a lower degree of stenosis experienced cerebral embolic events and had carotid endarterectomy. Was one of the causes that atherosclerosis might be a condition differing also in terms of pathogenicity? Such unexpected and intriguing findings evoked my curiosity for a more scientific approach to carotid atherosclerosis. The opportunity arose when I was invited to participate in the fourth survey of the Tromsø Study

    Deep learning for the detection and characterization of the carotid artery in ultrasound imaging

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    Treballs finals del Màster de Fonaments de Ciència de Dades, Facultat de matemàtiques, Universitat de Barcelona, Any: 2018, Tutor: Laura Igual Muñoz[en] Atherosclerosis is the main process causing most Cardio Vascular (CV) diseases. The measurement of Intima Media Thickness (IMT) in artery ultrasound images can be used to detect the presence of atherosclerotic plaques, which may appear in several territories of the artery. Moreover, it is well known that disruption of atherosclerotic plaque plays a crucial role in the pathogenesis of CV events. Several works have tried to automatize the detection of the IMT and the classification of the plaque by its composition. Traditionally, the methods used in the literature are semi-automatic. Furthermore, very little work has been done using Deep Learning approaches in order to solve this problems. In this thesis, we explore the effectiveness of Deep Learning techniques in attempting to automatize and improve the diagnosis of atheroma plaques. To achieve so we tackle the following problems: ultrasound image segmentation and plaque tissue classification. The techniques applied in this work are the following. For the segmentation of the common carotid artery IMT we replicate a state of the art Fully Convolutional Network approach and explore the implementation of a trained network to another dataset. Regarding the plaque classification problem, we explore the performance of Convolutional Neural Networks as well with two baseline methods. These techniques are applied on two datasets: REGICOR and NEFRONA. These datasets are provided by two research groups of IMIM and IRBLleida in collaboration in a larger project with the UB. A data exploration analysis is also presented on the patient’s data of NEFRONA to justify the importance of detecting the atherosclerotic plaques and thus the techniques we explore

    State-of-the-art CT and MR imaging and assessment of atherosclerotic carotid artery disease: standardization of scanning protocols and measurements - a consensus document by the European Society of Cardiovascular Radiology (ESCR)

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    The European Society of Cardiovascular Radiology (ESCR) is the European specialist society of cardiac and vascular imaging. This society's highest priority is the continuous improvement, development, and standardization of education, training, and best medical practice, based on experience and evidence. The present intra-society consensus is based on the existing scientific evidence and on the individual experience of the members of the ESCR writing group on carotid diseases, the members of the ESCR guidelines committee, and the members of the executive committee of the ESCR. The recommendations published herein reflect the evidence-based society opinion of ESCR. We have produced a twin-papers consensus, indicated through the documents as respectively "Part I" and "Part II." The first document (Part I) begins with a discussion of features, role, indications, and evidence for CT and MR imaging-based diagnosis of carotid artery disease for risk stratification and prediction of stroke (Section I). It then provides an extensive overview and insight into imaging-derived biomarkers and their potential use in risk stratification (Section II). Finally, detailed recommendations about optimized imaging technique and imaging strategies are summarized (Section III). The second part of this consensus paper (Part II) is focused on structured reporting of carotid imaging studies with CT/MR

    State-of-the-art CT and MR imaging and assessment of atherosclerotic carotid artery disease: standardization of scanning protocols and measurements-a consensus document by the European Society of Cardiovascular Radiology (ESCR).

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    The European Society of Cardiovascular Radiology (ESCR) is the European specialist society of cardiac and vascular imaging. This society's highest priority is the continuous improvement, development, and standardization of education, training, and best medical practice, based on experience and evidence. The present intra-society consensus is based on the existing scientific evidence and on the individual experience of the members of the ESCR writing group on carotid diseases, the members of the ESCR guidelines committee, and the members of the executive committee of the ESCR. The recommendations published herein reflect the evidence-based society opinion of ESCR. We have produced a twin-papers consensus, indicated through the documents as respectively "Part I" and "Part II." The first document (Part I) begins with a discussion of features, role, indications, and evidence for CT and MR imaging-based diagnosis of carotid artery disease for risk stratification and prediction of stroke (Section I). It then provides an extensive overview and insight into imaging-derived biomarkers and their potential use in risk stratification (Section II). Finally, detailed recommendations about optimized imaging technique and imaging strategies are summarized (Section III). The second part of this consensus paper (Part II) is focused on structured reporting of carotid imaging studies with CT/MR. KEY POINTS: • CT and MR imaging-based evaluation of carotid artery disease provides essential information for risk stratification and prediction of stroke. • Imaging-derived biomarkers and their potential use in risk stratification are evolving; their correct interpretation and use in clinical practice must be well-understood. • A correct imaging strategy and scan protocol will produce the best possible results for disease evaluation

    Doppler ultrasound measurement of Arterial Wall Motion (AWM)

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