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Wu Y, Barrere V, Ashir A, Han A, Chen X, Jerban S, Murphy ME, Andre MP, Shah SB, Chang EY. High-frequency Quantitative Ultrasound Imaging of Human Rotator Cuff Muscles: Assessment of Repeatability and Reproducibility. ULTRASONIC IMAGING 2024; 46:56-70. [PMID: 37981826 PMCID: PMC11170563 DOI: 10.1177/01617346231207404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
This study evaluated the repeatability and reproducibility of using high-frequency quantitative ultrasound (QUS) measurement of backscatter coefficient (BSC), grayscale analysis, and gray-level co-occurrence matrix (GLCM) textural analysis, to characterize human rotator cuff muscles. The effects of varying scanner settings across two different operators and two US systems were investigated in a healthy volunteer with normal rotator cuff muscles and a patient with chronic massive rotator cuff injury and substantial muscle degeneration. The results suggest that BSC is a promising method for assessing rotator cuff muscles in both control and pathological subjects, even when operators were free to adjust system settings (depth, level of focus, and time-gain compensation). Measurements were repeatable and reproducible across the different operators and ultrasound imaging platforms. In contrast, grayscale and GLCM analyses were found to be less reliable in this setting, with significant measurement variability. Overall, the repeatability and reproducibility measurements of BSC indicate its potential as a diagnostic tool for rotator cuff muscle evaluation.
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Affiliation(s)
- Yuanshan Wu
- Department of Bioengineering, University of California, San Diego, United States
- Department of Orthopaedic Surgery, University of California, San Diego, United States
| | - Victor Barrere
- Department of Orthopaedic Surgery, University of California, San Diego, United States
- Research Service, VA San Diego Healthcare System, San Diego, United States
| | - Aria Ashir
- Department of Radiology, Santa Barbara Cottage Hospital, Santa Barbara, United States
| | - Aiguo Han
- Department of Biomedical Engineering and Mechanics, Virginia Polytechnic Institute and State University, United States
| | - Xiaojun Chen
- Department of Radiology, University of California, San Diego, United States
- Fifth Affiliated Hospital of Sun Yat-sen University, Radiology, Zhu Hai, China
| | - Saeed Jerban
- Research Service, VA San Diego Healthcare System, San Diego, United States
- Department of Radiology, University of California, San Diego, United States
| | - Mark E. Murphy
- Orthopaedic Surgery Service, VA San Diego Healthcare System
| | - Michael P. Andre
- Research Service, VA San Diego Healthcare System, San Diego, United States
- Department of Radiology, University of California, San Diego, United States
| | - Sameer B. Shah
- Department of Bioengineering, University of California, San Diego, United States
- Department of Orthopaedic Surgery, University of California, San Diego, United States
- Research Service, VA San Diego Healthcare System, San Diego, United States
| | - Eric Y. Chang
- Research Service, VA San Diego Healthcare System, San Diego, United States
- Department of Radiology, University of California, San Diego, United States
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2
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Peng T, Dong Y, Di G, Zhao J, Li T, Ren G, Zhang L, Cai J. Boundary delineation in transrectal ultrasound images for region of interest of prostate. Phys Med Biol 2023; 68:195008. [PMID: 37652058 DOI: 10.1088/1361-6560/acf5c5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 08/31/2023] [Indexed: 09/02/2023]
Abstract
Accurate and robust prostate segmentation in transrectal ultrasound (TRUS) images is of great interest for ultrasound-guided brachytherapy for prostate cancer. However, the current practice of manual segmentation is difficult, time-consuming, and prone to errors. To overcome these challenges, we developed an accurate prostate segmentation framework (A-ProSeg) for TRUS images. The proposed segmentation method includes three innovation steps: (1) acquiring the sequence of vertices by using an improved polygonal segment-based method with a small number of radiologist-defined seed points as prior points; (2) establishing an optimal machine learning-based method by using the improved evolutionary neural network; and (3) obtaining smooth contours of the prostate region of interest using the optimized machine learning-based method. The proposed method was evaluated on 266 patients who underwent prostate cancer brachytherapy. The proposed method achieved a high performance against the ground truth with a Dice similarity coefficient of 96.2% ± 2.4%, a Jaccard similarity coefficient of 94.4% ± 3.3%, and an accuracy of 95.7% ± 2.7%; these values are all higher than those obtained using state-of-the-art methods. A sensitivity evaluation on different noise levels demonstrated that our method achieved high robustness against changes in image quality. Meanwhile, an ablation study was performed, and the significance of all the key components of the proposed method was demonstrated.
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Affiliation(s)
- Tao Peng
- School of Future Science and Engineering, Soochow University, Suzhou, People's Republic of China
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - Yan Dong
- Department of Ultrasonography, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Gongye Di
- Department of Ultrasonic, Taizhou People's Hospital Affiliated to Nanjing Medical University, Taizhou, People's Republic of China
| | - Jing Zhao
- Department of Ultrasound, Tsinghua University Affiliated Beijing Tsinghua Changgung Hospital, Beijing, People's Republic of China
| | - Tian Li
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China
| | - Ge Ren
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China
| | - Lei Zhang
- Medical Physics Graduate Program and Data Science Research Center, Duke Kunshan University, Kunshan, Jiangsu, People's Republic of China
| | - Jing Cai
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China
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3
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Mellucci PL, Bertanha M, Jaldin RG, Yoshida WB, Sobreira ML. Shear wave elastography for extracranial carotid atherosclerotic plaques: technical principles and how to do it. J Vasc Bras 2023; 22:e20220082. [PMID: 37790894 PMCID: PMC10545232 DOI: 10.1590/1677-5449.202200822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 06/12/2023] [Indexed: 10/05/2023] Open
Abstract
In the wake of studies targeting atherosclerotic plaques and searching for quantifiable variables that contribute additional information to therapeutic decision-making, plaque assessment using Shear Wave Elastography (SWE) is emerging as a reproducible and promising alternative. We used a single Logiq S8 device (General Electric, Boston, Massachusetts, United States) with an 8.5-11MHz multifrequency linear transducer at 10MHz in longitudinal section. We considered relevant criteria for image acquisition: adequate longitudinal insonation, differentiation of the intima-media complex, delineation of proximal and distal tunica adventitia and the vascular lumen, good visualization of the atherosclerotic plaque, cardiac cycle in ventricular diastole, and absence of incongruous changes. SWE is an emerging and extremely promising method for assessment of carotid plaques that may contribute to therapeutic decision-making based on characteristics related to the atherosclerotic plaque, with inter-device and inter-examiner reproducibility.
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Affiliation(s)
- Pedro Luciano Mellucci
- Universidade Estadual Paulista “Júlio de Mesquita Filho” - UNESP, Faculdade de Medicina de Botucatu - FMB, Botucatu, SP, Brasil.
| | - Matheus Bertanha
- Universidade Estadual Paulista “Júlio de Mesquita Filho” - UNESP, Faculdade de Medicina de Botucatu - FMB, Botucatu, SP, Brasil.
| | - Rodrigo Gibin Jaldin
- Universidade Estadual Paulista “Júlio de Mesquita Filho” - UNESP, Faculdade de Medicina de Botucatu - FMB, Botucatu, SP, Brasil.
| | - Winston Bonetti Yoshida
- Universidade Estadual Paulista “Júlio de Mesquita Filho” - UNESP, Faculdade de Medicina de Botucatu - FMB, Botucatu, SP, Brasil.
| | - Marcone Lima Sobreira
- Universidade Estadual Paulista “Júlio de Mesquita Filho” - UNESP, Faculdade de Medicina de Botucatu - FMB, Botucatu, SP, Brasil.
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4
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Bao J, Lv Y, Wang K, Wang Q, Chen Y, Dong Y, Zhu Y, Wang W. A Comparative Study of Ultrasound Attenuation Imaging, Controlled Attenuation Parameters, and Magnetic Resonance Spectroscopy for the Detection of Hepatic Steatosis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:1481-1489. [PMID: 36583414 DOI: 10.1002/jum.16158] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 12/02/2022] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVES To investigate the methodology and clinical application of ultrasound attenuation imaging (ATI) and comparative analyze the diagnostic performance of ATI and controlled attenuation parameters (CAP) for detecting and grading hepatic steatosis. METHODS A total of 159 patients with NAFLD were prospectively enrolled. CAP and ATI examinations were performed within a week before proton magnetic resonance spectroscopy (1 H-MRS). Ten liver attenuation coefficient (AC) measurements by ATI were obtained in each patient. The interclass correlation coefficients (ICCs) of the intraobserver consistencies and the ICCs between the median of the first two through the first nine measurements and all 10 measurements were calculated. The correlations between 1 H-MRS, CAP, biological data, and ATI were evaluated. The significant factors associated with ATI and the diagnostic performance of ATI and CAP for detecting hepatic steatosis was evaluated. RESULTS The median value of AC for detecting hepatic steatosis was 0.831 dB/cm/MHz. For the intraobserver consistency of ATI, the ICC was 0.931. Compared with 10 measurements, a minimum of four ATI measurements was required. The correlation of AC with hepatic fat fraction (HFF) was significantly higher than that of CAP (0.603 vs 0.326, P = .0015). The HFF and triglyceride (TG) were the significant factors for the ATI. The area under the receiver operating characteristics (ROC) curves of ATI and CAP were 0.939 and 0.788 for detecting ≥10% hepatic steatosis; 0.751 and 0.572 for detecting >33% hepatic steatosis. The cutoff values of ATI and CAP were 0.697 dB/cm/MHz and 310 dB/m for detecting ≥10% hepatic steatosis; 0.793 dB/cm/MHz and 328 dB/m for detecting >33% hepatic steatosis. The sensitivity of ATI and CAP were 85.92% and 52.11% for detecting ≥10% hepatic steatosis; 87.50% and 82.14% for detecting >33% hepatic steatosis. The specificity of ATI and CAP were 94.12% and 100% for detecting ≥10% hepatic steatosis; 54.37% and 43.69% for detecting >33% hepatic steatosis. CONCLUSIONS ATI technology showed excellent intraobserver consistency and the optimal minimum number of ATI measurements was 4. ATI is a promising noninvasive, quantitative and convenient tool for assessing hepatic steatosis.
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Affiliation(s)
- Jingwen Bao
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
- School of Medical Science, Hexi University, Zhangye, China
| | - Yueming Lv
- Department of General Surgery, Zhangye Second People's Hospital, Zhangye, China
| | - Kun Wang
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Quanwen Wang
- School of Medical Science, Hexi University, Zhangye, China
| | - Yanling Chen
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yi Dong
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yuli Zhu
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Wenping Wang
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
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5
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Mastroiacovo D, Ettorre E, Mengozzi A, Virdis A, Camerota A, Muselli M, Necozione S, Bocale R, Ferri C, Desideri G. Serum Uric Acid Levels Are Associated with the Echogenic Features of Carotid Plaque Vulnerability in Elderly Patients with Atherosclerotic Disease. Metabolites 2023; 13:693. [PMID: 37367851 DOI: 10.3390/metabo13060693] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 05/09/2023] [Accepted: 05/22/2023] [Indexed: 06/28/2023] Open
Abstract
Uric acid is a marker of inflammation and a risk factor for atherosclerosis that has been suggested to play a role in carotid plaque instability. Reduced atherosclerotic plaque echogenicity at ultrasound examination is associated with alarming histopathological features and inflammation. In this study, we investigated the relationship between serum uric acid (SUA) levels and echogenic patterns of plaque instability in elderly subjects with carotid atherosclerosis. Since uric acid metabolism largely depends on renal function, SUA levels were indexed for serum creatinine levels (SUA/SCr). We enrolled 108 patients aged 65 years or more (72.7 ± 5.9 years; 50 females and 58 males) who underwent carotid duplex ultrasound to evaluate plaque echogenicity by greyscale median (GSM). The regression analysis demonstrated a significant inverse association between the GSM and the SUA/SCr ratio (β: -0.567; 95% CI -0.751 to -0.384 and p < 0.0001). Stepwise multivariate regression showed that the SUA/SCr ratio explained 30.3% of GSM variability (β: -0.600; 95% CI -0.777/-0.424, p < 0.0001, and semi-partial correlation 0.303). After a mean period of 3.5 ± 0.5 years, 48 patients were reevaluated according to the same baseline study protocol. The regression analysis demonstrated a still significant inverse association between the GSM and the SUA/SCr ratio (β: -0.462; 95% CI -0.745 to -0.178 and p = 0.002). Stepwise multivariate regression showed that the SUA/SCr ratio explained 28.0% of GSM variability (coefficient -0.584, 95% CI -0.848/-0.319, p < 0.0001, and semi-partial R2 0.280). In conclusion, this study demonstrates that SUA levels indexed for serum creatinine are associated with the echogenic features of carotid plaque vulnerability in elderly patients with atherosclerotic disease. These data could suggest an influential role for uric acid metabolism in carotid plaque biology.
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Affiliation(s)
- Daniela Mastroiacovo
- Angiology Unit, Medical Department, "SS. Filippo and Nicola" Hospital, 67051 L'Aquila, Italy
| | - Evaristo Ettorre
- Department of Clinical, Internal Medicine, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Alessandro Mengozzi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
- Center for Translational and Experimental Cardiology (CTEC), Department of Cardiology, Zurich University Hospital, University of Zurich, 8952 Schlieren, Switzerland
- Institute of Life Sciences, Scuola Superiore Sant'Anna, 56126 Pisa, Italy
| | - Agostino Virdis
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Antonio Camerota
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - Mario Muselli
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - Stefano Necozione
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - Raffaella Bocale
- Division of Endocrine Surgery, Agostino Gemelli University Hospital Foundation Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), Catholic University of the Sacred Heart, 00168 Rome, Italy
| | - Claudio Ferri
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - Giovambattista Desideri
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy
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6
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Mastroiacovo D, Mengozzi A, Dentali F, Pomero F, Virdis A, Camerota A, Muselli M, Necozione S, Bocale R, Ferri C, Desideri G. Enhanced Carotid Plaque Echolucency Is Associated with Reduced Cognitive Performance in Elderly Patients with Atherosclerotic Disease Independently on Metabolic Profile. Metabolites 2023; 13:metabo13040478. [PMID: 37110137 PMCID: PMC10144528 DOI: 10.3390/metabo13040478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 02/27/2023] [Accepted: 03/22/2023] [Indexed: 03/29/2023] Open
Abstract
Vulnerable carotid atherosclerotic plaques are related to an increased risk of cognitive impairment and dementia in advanced age. In this study, we investigated the relationship between the echogenicity of carotid plaques and cognitive performance in patients with asymptomatic carotid atherosclerotic plaques. We enrolled 113 patients aged 65 years or more (72.4 ± 5.9 years) who underwent carotid duplex ultrasound to evaluate plaque echogenicity by grey-scale median (GSM) and neuropsychological tests to assess cognitive function. The GSM values at baseline were inversely correlated with the number of seconds required to complete Trail Makin Test (TMT) A (rho: −0.442; p < 0.0001), TMT B (rho: −0.460; p < 0.0001) and TMT B-A (rho: −0.333; p < 0.0001) and directly correlated with Mini Mental State Examination (MMSE) and Verbal Fluency Test (VFT) score (rho: 0.217; p = 0.021 and rho: 0.375; p < 0.0001, respectively) and the composite cognitive z-score (rho: 0.464; p < 0.0001). After a mean period of 3.5 ± 0.5 years, 55 patients were reevaluated according to the same baseline study protocol. Patients with baseline GSM value higher than the median value of 29 did not show any significant variation in the z-score. Instead, those with GSM ≤ 29 showed a significant worsening of z-score (−1.2; p = 0.0258). In conclusion, this study demonstrates the existence of an inverse relationship between the echolucency of carotid plaques and cognitive function in elderly patients with atherosclerotic carotid disease. These data suggest that the assessment of plaque echogenicity if used appropriately, might aid in identifying subjects at increased risk for cognitive dysfunction.
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Affiliation(s)
- Daniela Mastroiacovo
- Angiology Unit, Medical Department, “SS. Filippo and Nicola” Hospital, Avezzano, 67051 L’Aquila, Italy
| | - Alessandro Mengozzi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
- Center for Translational and Experimental Cardiology (CTEC), Department of Cardiology, Zurich University Hospital, University of Zurich, 8952 Schlieren, Switzerland
- Institute of Life Sciences, Scuola Superiore Sant’Anna, 56126 Pisa, Italy
| | - Francesco Dentali
- Department of Medicine and Surgery, Insubria University, 21100 Varese, Italy
| | - Fulvio Pomero
- Department of Internal Medicine, Michele and Pietro Ferrero Hospital, Verduno, 12060 Cuneo, Italy
| | - Agostino Virdis
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Antonio Camerota
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
| | - Mario Muselli
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
| | - Stefano Necozione
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
| | - Raffaella Bocale
- Division of Endocrine Surgery, Agostino Gemelli University Hospital Foundation IRCCS, Catholic University of the Sacred Heart, 00168 Rome, Italy
| | - Claudio Ferri
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
| | - Giovambattista Desideri
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
- Correspondence: ; Tel.: +39-0863499256
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7
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Mellucci PL, Bertanha M, Jaldin RG, Yoshida WB, Sobreira ML. Grayscale median (GSM) post-processing, posterizing, and color mapping for carotid ultrasound. J Vasc Bras 2023; 22:e20220081. [PMID: 36794172 PMCID: PMC9925061 DOI: 10.1590/1677-5449.202200811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 12/02/2022] [Indexed: 02/12/2023] Open
Abstract
Factors related to atherosclerotic plaques may indicate instability, such as ulcerations, intraplaque hemorrhages, lipid core, thin or irregular fibrous cap, and inflammation. The grayscale median (GSM) value is one of the most widespread methods of studying atherosclerotic plaques and it is therefore important to comprehensively standardize image post-processing. Post-processing was performed using Photoshop 23.1.1.202. Images were standardized by adjusting the grayscale histogram curves, setting the darkest point of the vascular lumen (blood) to zero and the distal adventitia to 190. Posterization and color mapping were performed. A methodology that presents the current state of the art in an accessible and illustrative way should contribute to the dissemination of GSM analysis. This article describes and illustrates the process step by step.
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8
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Danko V, Jüngert J, Schuessler S, Buehler A, Klett D, Federle A, Roos A, Lochmüller H, Neurath MF, Woelfle J, Trollmann R, Waldner MJ, Knieling F, Regensburger AP, Wagner AL. Hybrid reflected-ultrasound computed tomography versus B-mode-ultrasound for muscle scoring in spinal muscular atrophy. J Neuroimaging 2023; 33:393-403. [PMID: 36627228 DOI: 10.1111/jon.13081] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/19/2022] [Accepted: 12/27/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND AND PURPOSE Novel light- and sound-based technologies like multispectral optoacoustic tomography (MSOT) with co-registered reflected-ultrasound computed tomography (RUCT) could add additional value to conventional ultrasound (US) for disease phenotyping in pediatric spinal muscular atrophy (SMA). The aim of this study was to investigate the quality of RUCT compared to US for qualitative and quantitative assessment of imaging neuromuscular disorders. METHODS Subanalyzing the MSOT SMA study, 288 RUCT and 276 US images from 10 SMA patients (mean age 9.0 ± 3.7) and 10 gender- and age-matched healthy volunteers (HV; mean age 8.7 ± 4.3) were analyzed for quantitative (grayscale levels [GSLs]) and qualitative (echogenicity, distribution pattern, Heckmatt scale, and muscle texture) muscle changes. RUCT and US measures were further correlated with clinical standard motor outcomes. RESULTS Quantitative agreement using GSLs revealed significantly higher GSLs in muscles of SMA patients compared to healthy muscles in both techniques (US mean GSL [SD] SMA vs. HV: 110.70 [27.8] vs. 68.85 [19.2], p < .0001; RUCT mean GSL [SD] SMA vs. HV: 91.81 [21.8] vs. 59.86 [8.2], p < .0001) with good correlation with motor outcome tests, respectively. Qualitative agreement between methods for muscle composition was excellent for differentiation of pathological versus healthy muscles, echogenicity, and distribution pattern, moderate for Heckmatt scale, and poor for muscle texture. CONCLUSIONS The data suggest that RUCT may allow the assessment of basic qualitative and quantitative measures for muscular diseases with comparable results to conventional US.
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Affiliation(s)
- Vera Danko
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg, Erlangen, Germany.,Pediatric Experimental and Translational Imaging Laboratory (PETI-Lab), University Hospital Erlangen, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Jörg Jüngert
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Stephanie Schuessler
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Adrian Buehler
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg, Erlangen, Germany.,Pediatric Experimental and Translational Imaging Laboratory (PETI-Lab), University Hospital Erlangen, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Daniel Klett
- Medical Department 1, University Hospital Erlangen, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg, Erlangen, Germany.,German Center Immunotherapy, University Hospital Erlangen, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Anna Federle
- Medical Department 1, University Hospital Erlangen, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg, Erlangen, Germany.,German Center Immunotherapy, University Hospital Erlangen, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Andreas Roos
- Department of Pediatric Neurology, Developmental Neurology and Social Pediatrics, University of Duisburg-Essen, Essen, Germany.,Children's Hospital of Eastern Ontario Research Institute; Division of Neurology, Department of Medicine, The Ottawa Hospital; and Brain and Mind Research Institute, University of Ottawa, Ottawa, Canada.,Department of Neurology, Heimer Institute for Muscle Research, University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
| | - Hanns Lochmüller
- Children's Hospital of Eastern Ontario Research Institute; Division of Neurology, Department of Medicine, The Ottawa Hospital; and Brain and Mind Research Institute, University of Ottawa, Ottawa, Canada
| | - Markus F Neurath
- Medical Department 1, University Hospital Erlangen, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg, Erlangen, Germany.,German Center Immunotherapy, University Hospital Erlangen, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Joachim Woelfle
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Regina Trollmann
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Maximilian J Waldner
- Medical Department 1, University Hospital Erlangen, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg, Erlangen, Germany.,German Center Immunotherapy, University Hospital Erlangen, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Ferdinand Knieling
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg, Erlangen, Germany.,Pediatric Experimental and Translational Imaging Laboratory (PETI-Lab), University Hospital Erlangen, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Adrian P Regensburger
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg, Erlangen, Germany.,Pediatric Experimental and Translational Imaging Laboratory (PETI-Lab), University Hospital Erlangen, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Alexandra L Wagner
- Pediatric Experimental and Translational Imaging Laboratory (PETI-Lab), University Hospital Erlangen, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg, Erlangen, Germany.,Center for Chronically Sick Children, Charité-Universitätsmedizin Berlin, Berlin, Germany
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9
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Mellucci Filho PL, Bertanha M, Jaldin RG, Yoshida WB, Sobreira ML. Grayscale median (GSM) post-processing, posterizing, and color mapping for carotid ultrasound. J Vasc Bras 2023. [DOI: 10.1590/1677-5449.202200812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
Abstract Factors related to atherosclerotic plaques may indicate instability, such as ulcerations, intraplaque hemorrhages, lipid core, thin or irregular fibrous cap, and inflammation. The grayscale median (GSM) value is one of the most widespread methods of studying atherosclerotic plaques and it is therefore important to comprehensively standardize image post-processing. Post-processing was performed using Photoshop 23.1.1.202. Images were standardized by adjusting the grayscale histogram curves, setting the darkest point of the vascular lumen (blood) to zero and the distal adventitia to 190. Posterization and color mapping were performed. A methodology that presents the current state of the art in an accessible and illustrative way should contribute to the dissemination of GSM analysis. This article describes and illustrates the process step by step.
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10
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Sett A, Foo GWC, Kenna KR, Sutton RJ, Perkins EJ, Sourial M, Rogerson SR, Manley BJ, Davis PG, Pereira-Fantini PM, Tingay DG. Quantitative lung ultrasound detects dynamic changes in lung recruitment in the preterm lamb. Pediatr Res 2022; 93:1591-1598. [PMID: 36167816 PMCID: PMC10172106 DOI: 10.1038/s41390-022-02316-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/24/2022] [Accepted: 09/07/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Lung ultrasound (LUS) may not detect small, dynamic changes in lung volume. Mean greyscale measurement using computer-assisted image analysis (Q-LUSMGV) may improve the precision of these measurements. METHODS Preterm lambs (n = 40) underwent LUS of the dependent or non-dependent lung during static pressure-volume curve mapping. Total and regional lung volumes were determined using the super-syringe technique and electrical impedance tomography. Q-LUSMGV and gold standard measurements of lung volume were compared in 520 images. RESULTS Dependent Q-LUSMGV moderately correlated with total lung volume (rho = 0.60, 95% CI 0.51-0.67) and fairly with right whole (rho = 0.39, 0.27-0.49), central (rho = 0.38, 0.27-0.48), ventral (rho = 0.41, 0.31-0.51) and dorsal regional lung volumes (rho = 0.32, 0.21-0.43). Non-dependent Q-LUSMGV moderately correlated with total lung volume (rho = 0.57, 0.48-0.65) and fairly with right whole (rho = 0.43, 0.32-0.52), central (rho = 0.46, 0.35-0.55), ventral (rho = 0.36, 0.25-0.47) and dorsal lung volumes (rho = 0.36, 0.25-0.47). All correlation coefficients were statistically significant. Distinct inflation and deflation limbs, and sonographic pulmonary hysteresis occurred in 95% of lambs. The greatest changes in Q-LUSMGV occurred at the opening and closing pressures. CONCLUSION Q-LUSMGV detected changes in total and regional lung volume and offers objective quantification of LUS images, and may improve bedside discrimination of real-time changes in lung volume. IMPACT Lung ultrasound (LUS) offers continuous, radiation-free imaging that may play a role in assessing lung recruitment but may not detect small changes in lung volume. Mean greyscale image analysis using computer-assisted quantitative LUS (Q-LUSMGV) moderately correlated with changes in total and regional lung volume. Q-LUSMGV identified opening and closing pressure and pulmonary hysteresis in 95% of lambs. Computer-assisted image analysis may enhance LUS estimation of lung recruitment at the bedside. Future research should focus on improving precision prior to clinical translation.
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Affiliation(s)
- Arun Sett
- Neonatal Research, Murdoch Children's Research Institute, Parkville, VIC, Australia. .,Newborn Research Centre, The Royal Women's Hospital, Parkville, VIC, Australia. .,Joan Kirner Women's and Children's Hospital, Western Health, St Albans, VIC, Australia. .,Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, VIC, Australia. .,Paediatric Infant Perinatal Emergency Retrieval, The Royal Children's Hospital, Parkville, VIC, Australia.
| | - Gillian W C Foo
- Newborn Research Centre, The Royal Women's Hospital, Parkville, VIC, Australia
| | - Kelly R Kenna
- Neonatal Research, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Rebecca J Sutton
- Neonatal Research, Murdoch Children's Research Institute, Parkville, VIC, Australia.,Translational Research Unit, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Elizabeth J Perkins
- Neonatal Research, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Magdy Sourial
- Translational Research Unit, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Sheryle R Rogerson
- Newborn Research Centre, The Royal Women's Hospital, Parkville, VIC, Australia.,Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, VIC, Australia.,Paediatric Infant Perinatal Emergency Retrieval, The Royal Children's Hospital, Parkville, VIC, Australia
| | - Brett J Manley
- Neonatal Research, Murdoch Children's Research Institute, Parkville, VIC, Australia.,Newborn Research Centre, The Royal Women's Hospital, Parkville, VIC, Australia.,Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, VIC, Australia
| | - Peter G Davis
- Neonatal Research, Murdoch Children's Research Institute, Parkville, VIC, Australia.,Newborn Research Centre, The Royal Women's Hospital, Parkville, VIC, Australia.,Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, VIC, Australia
| | - Prue M Pereira-Fantini
- Neonatal Research, Murdoch Children's Research Institute, Parkville, VIC, Australia.,Newborn Research Centre, The Royal Women's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - David G Tingay
- Neonatal Research, Murdoch Children's Research Institute, Parkville, VIC, Australia.,Newborn Research Centre, The Royal Women's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia.,Department of Neonatology, The Royal Children's Hospital, Parkville, VIC, Australia
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11
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Fang J, Ting YN, Chen YW. Quantitative Assessment of Lung Ultrasound Grayscale Images Based on Shannon Entropy for the Detection of Pulmonary Aeration: An Animal Study. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:1699-1711. [PMID: 34698398 DOI: 10.1002/jum.15851] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 08/23/2021] [Accepted: 09/21/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Lung ultrasound (LUS) is a radiation-free, affordable, and bedside monitoring method that can detect changes in pulmonary aeration before hypoxic damage. However, visual scoring methods of LUS only enable subjective diagnosis. Therefore, quantitative analysis of LUS is necessary for obtaining objective information on pulmonary aeration. Because raw data are not always available in conventional ultrasound systems, Shannon entropy (ShanEn) of information theory without the requirement of raw data is valuable. In this study, we explored the feasibility of ShanEn estimated through grayscale histogram (GSH) analysis of LUS images for the quantification of pulmonary aeration. METHODS Different degrees of pulmonary aeration caused by edema was induced in 32 male New Zealand rabbits intravenously injected with 0.1 mL/kg saline (the control group) and 0.025, 0.05, and 0.1 mL/kg oleic acid (mild, moderate, and severe groups, respectively). In vivo grayscale LUS images were acquired using a commercial point-of-care ultrasound system for estimation of GSH and corresponding ShanEn. Both lungs of each rabbit were dissected, weighed, and dried to determine the wet weight-to-dry weight ratio (W/D) through gravimetry. RESULTS The determination coefficients of linear correlations between ShanEn and W/D increased from 0.0487 to 0.7477 with gain and dynamic range (DR). In contrast to visual scoring methods of pulmonary aeration that use median gain and low DR, ShanEn for quantifying pulmonary aeration requires high gain and DR. CONCLUSION The current findings indicate that ShanEn estimated through GSH analysis of LUS images acquired using conventional ultrasonic imaging systems has great potential to provide objective information on pulmonary aeration.
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Affiliation(s)
- Jui Fang
- x-Dimension Center for Medical Research and Translation, China Medical University Hospital, Taichung City, Taiwan
| | - Yen-Nien Ting
- x-Dimension Center for Medical Research and Translation, China Medical University Hospital, Taichung City, Taiwan
| | - Yi-Wen Chen
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung City, Taiwan
- High Performance Materials Institute for xD Printing, Asia University, Taichung City, Taiwan
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12
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Hughey CM, Vuong BW, Ribaudo HB, Mitchell CCK, Korcarz CE, Hodis HN, Currier JS, Stein JH. Grayscale Ultrasound Texture Features of Carotid and Brachial Arteries in People With HIV Infection Before and After Antiretroviral Therapy. J Am Heart Assoc 2022; 11:e024142. [PMID: 35179037 PMCID: PMC9075086 DOI: 10.1161/jaha.121.024142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background We aimed to investigate novel grayscale ultrasound characteristics of the carotid and brachial arteries in people with HIV infection before and after starting initial antiretroviral therapy (ART). Methods and Results We performed grayscale ultrasound image analyses of the common carotid artery (CCA) and brachial artery before and after receipt of 1 of 3 randomly allocated ART regimens. We measured arterial wall echogenicity (grayscale median), contrast (gray-level difference statistic method), and entropy. These measures and their changes were compared with atherosclerotic cardiovascular disease risk factors, measures of HIV disease severity, and inflammatory biomarkers before and after ART. Changes in the grayscale measures were evaluated within and between ART arms. Among 201 ART-naïve people with HIV, higher systolic blood pressure, higher body mass index, lower CD4+ T cells, and non-Hispanic White race and ethnicity were associated independently with lower CCA grayscale median. Changes in each CCA grayscale measure from baseline to 144 weeks correlated with changes in soluble CD163: grayscale median (ρ=-0.17; P=0.044), gray-level difference statistic-contrast (ρ=-0.19; P=0.024), and entropy (ρ=-0.21; P=0.016). Within the atazanavir/ritonavir arm, CCA entropy increased (adjusted β=0.023 [95% CI, 0.001-0.045]; P=0.04), but no other within-arm changes in grayscale measures were seen. Correlations of brachial artery grayscale measures were weaker. Conclusions In ART-naïve people with HIV, CCA grayscale ultrasound measures were associated with atherosclerotic cardiovascular disease risk factors and lower grayscale median was associated with lower CD4+ T cells. Reductions in soluble CD163 with initial ART were associated with improvements in all 3 CCA grayscale measures, suggesting that reductions in macrophage activation with ART initiation may lead to less arterial injury. Registration URL: https://clinicaltrials.gov/; Unique identifiers: NCT00811954; NCT00851799.
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Affiliation(s)
| | - Belinda W Vuong
- University of Wisconsin School of Medicine and Public Health Madison WI
| | | | | | - Claudia E Korcarz
- University of Wisconsin School of Medicine and Public Health Madison WI
| | - Howard N Hodis
- Keck School of Medicine of University of Southern California Los Angeles CA
| | - Judith S Currier
- David Geffen School of Medicine at University of California-Los Angeles Los Angeles CA
| | - James H Stein
- University of Wisconsin School of Medicine and Public Health Madison WI
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13
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Formenti P, Umbrello M, Castagna V, Cenci S, Bichi F, Pozzi T, Bonifazi M, Coppola S, Chiumello D. Respiratory and peripheral muscular ultrasound characteristics in ICU COVID 19 ARDS patients. J Crit Care 2022; 67:14-20. [PMID: 34600218 PMCID: PMC8480969 DOI: 10.1016/j.jcrc.2021.09.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 08/06/2021] [Accepted: 09/05/2021] [Indexed: 01/08/2023]
Abstract
PURPOSE Severe cases of coronavirus disease 2019 develop ARDS requiring admission to the ICU. This study aimed to investigate the ultrasound characteristics of respiratory and peripheral muscles of patients affected by COVID19 who require mechanical ventilation. MATERIALS AND METHODS This is a prospective observational study. We performed muscle ultrasound at the admission of ICU in 32 intubated patients with ARDS COVID19. The ultrasound was comprehensive of thickness and echogenicity of both parasternal intercostal and diaphragm muscles, and cross-sectional area and echogenicity of the rectus femoris. RESULTS Patients who survived showed a significantly lower echogenicity score as compared with those who did not survive for both parasternal intercostal muscles. Similarly, the diaphragmatic echogenicity was significantly different between alive or dead patients. There was a significant correlation between right parasternal intercostal or diaphragm echogenicity and the cumulative fluid balance and urine protein output. Similar results were detected for rectus femoris echogenicity. CONCLUSIONS The early changes detected by echogenicity ultrasound suggest a potential benefit of proactive early therapies designed to preserve respiratory and peripheral muscle architecture to reduce days on MV, although what constitutes a clinically significant change in muscle echogenicity remains unknown.
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Affiliation(s)
- P. Formenti
- SC Anestesia e Rianimazione, Ospedale San Paolo – Polo Universitario, ASST Santi Paolo e Carlo, Milan, Italy,Corresponding author at: SC Anestesia e Rianimazione, ASST Santi Paolo e Carlo, Via Di Rudinì, 8, 20142 Milan, Italy
| | - M. Umbrello
- SC Anestesia e Rianimazione, Ospedale San Paolo – Polo Universitario, ASST Santi Paolo e Carlo, Milan, Italy
| | - V. Castagna
- Dipartimento di fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy
| | - S. Cenci
- Dipartimento di fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy
| | - F. Bichi
- Dipartimento di fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy
| | - T. Pozzi
- Dipartimento di fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy
| | - M. Bonifazi
- SC Anestesia e Rianimazione, Ospedale San Paolo – Polo Universitario, ASST Santi Paolo e Carlo, Milan, Italy
| | - S. Coppola
- SC Anestesia e Rianimazione, Ospedale San Paolo – Polo Universitario, ASST Santi Paolo e Carlo, Milan, Italy
| | - D. Chiumello
- SC Anestesia e Rianimazione, Ospedale San Paolo – Polo Universitario, ASST Santi Paolo e Carlo, Milan, Italy,Dipartimento di fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy,Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy,Centro Ricerca Coordinata di Insufficienza Respiratoria, Università degli Studi di Milano, Milan, Italy
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14
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Mitchell C, Korcarz CE, Zagzebski JA, Stein JH. Effects of ultrasound technology advances on measurement of carotid intima-media thickness: A review. Vasc Med 2020; 26:81-85. [PMID: 33203316 DOI: 10.1177/1358863x20969826] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In this review, we describe how technological advances in ultrasound imaging related to transducer construction and image processing fundamentally alter generation of ultrasound images to produce better quality images with higher resolution. However, carotid intima-media thickness (IMT) measurements made from images acquired on modern ultrasound systems are not comparable to historical population nomograms that were used to determine wall thickness thresholds that inform atherosclerotic cardiovascular disease risk. Because it is nearly impossible to replicate instrumentation settings that were used to create the reference carotid IMT nomograms and to place an individual's carotid IMT value in or above a clinically relevant percentile, carotid IMT measurements have a very limited role in clinical medicine, but remain a useful research tool when instrumentation, presets, image acquisition, and measurements can be standardized. In addition to new validation studies, it would be useful for the ultrasound imaging community to reach a consensus regarding technical aspects of ultrasound imaging acquisition, processing, and display for blood vessels so standard presets and imaging approaches could reliably yield the same measurements.
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Affiliation(s)
- Carol Mitchell
- Department of Medicine, Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Claudia E Korcarz
- Department of Medicine, Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - James A Zagzebski
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - James H Stein
- Department of Medicine, Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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15
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Steffel CN, Salamat S, Cook TD, Wilbrand SM, Dempsey RJ, Mitchell CC, Varghese T. Attenuation Coefficient Parameter Computations for Tissue Composition Assessment of Carotid Atherosclerotic Plaque in Vivo. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:1513-1532. [PMID: 32291105 PMCID: PMC7216316 DOI: 10.1016/j.ultrasmedbio.2020.02.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 01/17/2020] [Accepted: 02/26/2020] [Indexed: 06/11/2023]
Abstract
Quantitative ultrasound has been used to assess carotid plaque tissue composition. Here, we compute the attenuation coefficient (AC) in vivo with the optimum power spectral shift estimator (OPSSE) and reference phantom method (RPM), extract AC parameters and form parametric maps. Differences between OPSSE and RPM AC parameters are computed. Relationships between AC parameters, surgical scores and histopathology assessments are examined. Kendall's τ correlations between OPSSE AC and surgical scores are significant, including those between cholesterol and Standard Deviation (adjusted p = 0.038); thrombus and Minimum (adjusted p = 0.002), Maximum (adjusted p = 0.021) and Standard Deviation (adjusted p = 0.001); ulceration and Average (adjusted p = 0.033), Median (unadjusted p = 0.013), Maximum (unadjusted p = 0.039) and Mode (adjusted p = 0.009). The strongest correlations with histopathology are percentage cholesterol and Median OPSSE (unadjusted p = 0.007); percentage hemorrhage and Minimum OPSSE (adjusted p < 0.001); hemosiderin score and Median OPSSE (adjusted p = 0.010); and percentage calcium and Percentage Non-physical RPM Pixels (unadjusted p = 0.014). Kruskal-Wallis H and Dunn's post hoc tests have the ability to distinguish between groups (p < 0.05). Results suggest AC parameters may assist in vivo evaluation of carotid plaque vulnerability.
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Affiliation(s)
- Catherine N Steffel
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
| | - Shahriar Salamat
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Thomas D Cook
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Stephanie M Wilbrand
- Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Robert J Dempsey
- Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Carol C Mitchell
- Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Tomy Varghese
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
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16
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Mitchell CC, Korcarz CE, Gepner AD, Nye R, Young RL, Matsuzaki M, Post WS, Kaufman JD, McClelland RL, Stein JH. Carotid Artery Echolucency, Texture Features, and Incident Cardiovascular Disease Events: The MESA Study. J Am Heart Assoc 2019; 8:e010875. [PMID: 30681393 PMCID: PMC6405595 DOI: 10.1161/jaha.118.010875] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 11/27/2018] [Indexed: 02/07/2023]
Abstract
Background We hypothesized that measures of common carotid artery echolucency and grayscale texture features were associated with cardiovascular disease ( CVD ) risk factors and could predict CVD events. Methods and Results Using a case-cohort design, we measured common carotid artery ultrasound images from 1788 participants in Exam 1 of the MESA study (Multi-Ethnic Study of Atherosclerosis) to derive 4 grayscale features: grayscale median, entropy, gray level difference statistic-contrast, and spatial gray level dependence matrices-angular second moment. CVD risk factor associations were determined by linear regression. Cox proportional hazard models with inverse selection probability weighting and adjustments for age, sex, race/ethnicity, CVD risk factors, and C-reactive protein were used to determine if standardized values for grayscale median, entropy, gray level difference statistic-contrast, and spatial gray level dependence matrices-angular second moment could predict incident coronary heart disease, stroke, and total CVD events over a median 13 years follow-up. Participants were mean ( SD ) 63.1 (10.3) years of age, 52.6% female, 32.1% white, 27.8% black, 23.3% Hispanic, and 16.8% Chinese. There were 283 coronary heart disease, 120 stroke, and 416 CVD events. Several associations of grayscale features with CVD risk factors were identified. In fully adjusted models, higher gray level difference statistic-contrast was associated with a lower risk of incident coronary heart disease (hazard ratio 0.82, 95% CI 0.71-0.94, padj=0.005) and CVD events (hazard ratio 0.87, 95% CI 0.77-0.98, padj=0.018); higher spatial gray level dependence matrices-angular second moment was associated with a higher risk of CVD events (hazard ratio 1.09, 95% CI 1.00-1.19, padj=0.044). Conclusions Gray level difference statistic-contrast and spatial gray level dependence matrices-angular second moment predicted CVD events independent of risk factors, indicating their potential use as biomarkers to assess future CVD risk.
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Affiliation(s)
- Carol C. Mitchell
- Division of Cardiovascular MedicineDepartment of MedicineSchool of Medicine and Public HealthUniversity of WisconsinMadisonWI
| | - Claudia E. Korcarz
- Division of Cardiovascular MedicineDepartment of MedicineSchool of Medicine and Public HealthUniversity of WisconsinMadisonWI
| | - Adam D. Gepner
- Division of Cardiovascular MedicineDepartment of MedicineSchool of Medicine and Public HealthUniversity of WisconsinMadisonWI
- Department of MedicineDivision of Cardiovascular MedicineWilliam S. Middleton Memorial Veterans HospitalMadisonWI
| | - Rebecca Nye
- Division of Cardiovascular MedicineDepartment of MedicineSchool of Medicine and Public HealthUniversity of WisconsinMadisonWI
| | | | - Mika Matsuzaki
- Department of BiostatisticsUniversity of WashingtonSeattleWA
| | - Wendy S. Post
- Division of CardiologyDepartment of MedicineJohns Hopkins UniversityBaltimoreMD
| | - Joel D. Kaufman
- Departments of Environmental & Occupational Health Sciences, Medicine, and EpidemiologyUniversity of WashingtonSeattleWA
| | | | - James H. Stein
- Division of Cardiovascular MedicineDepartment of MedicineSchool of Medicine and Public HealthUniversity of WisconsinMadisonWI
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