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Ziyambe B, Yahya A, Mushiri T, Tariq MU, Abbas Q, Babar M, Albathan M, Asim M, Hussain A, Jabbar S. A Deep Learning Framework for the Prediction and Diagnosis of Ovarian Cancer in Pre- and Post-Menopausal Women. Diagnostics (Basel) 2023; 13:diagnostics13101703. [PMID: 37238188 DOI: 10.3390/diagnostics13101703] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/17/2023] [Accepted: 04/25/2023] [Indexed: 05/28/2023] Open
Abstract
Ovarian cancer ranks as the fifth leading cause of cancer-related mortality in women. Late-stage diagnosis (stages III and IV) is a major challenge due to the often vague and inconsistent initial symptoms. Current diagnostic methods, such as biomarkers, biopsy, and imaging tests, face limitations, including subjectivity, inter-observer variability, and extended testing times. This study proposes a novel convolutional neural network (CNN) algorithm for predicting and diagnosing ovarian cancer, addressing these limitations. In this paper, CNN was trained on a histopathological image dataset, divided into training and validation subsets and augmented before training. The model achieved a remarkable accuracy of 94%, with 95.12% of cancerous cases correctly identified and 93.02% of healthy cells accurately classified. The significance of this study lies in overcoming the challenges associated with the human expert examination, such as higher misclassification rates, inter-observer variability, and extended analysis times. This study presents a more accurate, efficient, and reliable approach to predicting and diagnosing ovarian cancer. Future research should explore recent advances in this field to enhance the effectiveness of the proposed method further.
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Affiliation(s)
- Blessed Ziyambe
- Department of Electrical Engineering, Harare Polytechnic College, Causeway Harare P.O. Box CY407, Zimbabwe
| | - Abid Yahya
- Department of Electrical, Computer and Telecommunications Engineering, Botswana International University of Science and Technology, Palapye 10071, Botswana
| | - Tawanda Mushiri
- Department of Industrial and Mechatronics Engineering, Faculty of Engineering & the Built Environment, University of Zimbabwe, Mt. Pleasant, 630 Churchill Avenue, Harare, Zimbabwe
| | | | - Qaisar Abbas
- College of Computer and Information Sciences, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 11432, Saudi Arabia
| | - Muhammad Babar
- Robotics and Internet of Things Laboratory, Prince Sultan University, Riyadh 12435, Saudi Arabia
| | - Mubarak Albathan
- College of Computer and Information Sciences, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 11432, Saudi Arabia
| | - Muhammad Asim
- EIAS Data Science Laboratory, Prince Sultan University, Riyadh 12435, Saudi Arabia
| | - Ayyaz Hussain
- Department of Computer Science, Quaid-i-Azam University, Islamabad 44000, Pakistan
| | - Sohail Jabbar
- College of Computer and Information Sciences, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 11432, Saudi Arabia
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Zaid T, Biradar N, Sonth MV, Gowre SC, Gadgay B. FDADE: Flow direction algorithm with differential evolution for measurement of intima-media thickness of the carotid artery in ultrasound images. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2022.104350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Stratification of risk of atherosclerotic plaque using Hu’s moment invariants of segmented ultrasonic images. BIOMED ENG-BIOMED TE 2022; 67:391-402. [DOI: 10.1515/bmt-2021-0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 06/21/2022] [Indexed: 11/15/2022]
Abstract
Abstract
Myocardial infarction is one of the major life-threatening diseases. The cause is atherosclerosis i.e. the occlusion of the coronary artery by deposition of plaque on its walls. The severity of plaque deposition in the artery depends on the characteristics of the plaque. Hence, the classification of the type of plaque is crucial for assessing the risk of atherosclerosis and predicting the chances of myocardial infarction. This paper proposes prediction of atherosclerotic risk by non-invasive ultrasound image segmentation and textural feature extraction. The intima-media complex is segmented using a snakes-based segmentation algorithm on the arterial wall in the ultrasound images. Then, the plaque is extracted from the segmented intima-media complex. The features of the plaque are obtained by computing Hu’s moment invariants. Visual pattern recognition independent of position, size, orientation and parallel projection could be done using these moment invariants. For the classification of the features of the plaque, an SVM classifier is used. The performance shows improvement in accuracy using lesser number of features than previous works. The reduction in feature size is achieved by incorporating segmentation in the pre-processing stage. Tenfold cross-validation protocol is used for training and testing the classifier. An accuracy of 97.9% is obtained with only two features. This proposed technique could work as an adjunct tool in quick decision-making for cardiologists and radiologists. The segmentation step introduced in the preprocessing stage improved the feature extraction technique. An improvement in performance is achieved with much less number of features.
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The Role of Physical Activity Status in the Relationship between Obesity and Carotid Intima-Media Thickness (CIMT) in Urban South African Teachers: The SABPA Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106348. [PMID: 35627885 PMCID: PMC9141222 DOI: 10.3390/ijerph19106348] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/13/2022] [Accepted: 05/18/2022] [Indexed: 02/01/2023]
Abstract
Globally, the prevalence of physical inactivity and obesity are on the rise, which may increase carotid intima-media thickness (CIMT) as a marker of subclinical atherosclerosis. This study assessed the association between physical activity (PA), obesity, and CIMT. A cross-sectional study design was used, including a sub-sample (n = 216) of teachers who participated in the Sympathetic Activity and Ambulatory Blood Pressure in Africans (SAPBA) study. Measurements included the following: physical activity status (measured with ActiHeart devices over 7 consecutive days), body mass index (BMI), waist circumference (WC), waist-to-height ratio (WtHR), CIMT (measured by SonoSite Micromax ultrasound), blood pressure (BP), fasting C-reactive protein (CRP), and cholesterol and glucose levels. Data were analysed using the Statistical Package for Social Science. One-third of the teachers were physically inactive (33%) and had low-grade inflammation CRP ≥ 3 mg/L (41%). Males were more sedentary and had higher BP and CIMT (p < 0.05). Independent of age and sex, WC or central obesity was 2.63 times more likely (p = 0.02) to contribute to atherosclerosis, especially in females (OR: 4.23, p = 0.04). PA levels were insignificantly and negatively (β −0.034; 0.888; 0.240) related to subclinical atherosclerosis. The cardiovascular disease risk profiles and limited PA status may have curbed the beneficial impact of PA on the obesity and atherosclerosis.
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Carotid-femoral pulse wave velocity acquisition methods and their associations with cardiovascular risk factors and subclinical biomarkers of vascular health. J Hypertens 2021; 40:658-665. [PMID: 34879390 DOI: 10.1097/hjh.0000000000003055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Different methods to measure carotid-femoral pulse wave velocity (CFPWV) may affect the measurements obtained and influence the association between CFPWV, cardiovascular risk factors and biomarkers of subclinical vascular health. The estimation of distance between the carotid and femoral artery measurement sites (the arterial path length) is particularly problematic. METHOD We determined if CFPWV and equation-based estimates of CFPWV were influenced by arterial path length and if this affected the association of CFPWV with cardiovascular risk factors and subclinical vascular biomarkers. The CFPWV derived from the measurement of surface distance (CFPWV-D), arterial path length formula (CFPWV-F), and estimated CFPWV (ePWV) were obtained from 489 older adults (67.2 ± 8.8 years). Macrovascular [carotid artery: lumen diameter (LD), inter-adventitial diameter (IAD), intima-media thickness (IMT) and total plaque area (TPA)] and microvascular [reactive hyperaemia index and urinary albumin-creatinine ratio (UACR)] biomarkers were also measured. RESULTS CFPWV-D was significantly greater than CFPWV-F [9.6 (8.0-11.2) vs. 8.9 (7.6-10.5) m/s, P < 0.001], because of estimated path length being longer in CFPWV-D than CFPWV-F (495.4 ± 44.8 vs. 465.3 ± 20.6 mm, P < 0.001). ePWV was significantly greater than both CFPWV-F and CFPWV-D [11.0 (10.0-12.2) m/s, P < 0.001]. The three CFPWV methods were similarly associated with LD, IAD, IMT, TPA and UACR but not with cardiovascular risk factors. CONCLUSION Different methods to measure CFPWV affect the derived measurement values and the association with cardiovascular risk factors but not the association with subclinical biomarkers of vascular health. These hitherto unreported observations are important considerations in experimental design, data interpretation and of particular importance, comparison between studies where CFPWV is measured.
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Subramaniam S, Jayanthi KB, Rajasekaran C, Sunder C. Measurement of Intima-Media Thickness Depending on Intima Media Complex Segmentation by Deep Neural Networks. JOURNAL OF MEDICAL IMAGING AND HEALTH INFORMATICS 2021. [DOI: 10.1166/jmihi.2021.3841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Intima Media Thickness (IMT) of the carotid artery is an important marker indicating the sign of cardiovascular disease. Automated measurement of IMT requires segmentation of intima media complex (IMC).Traditional methods which use shape, color and texture for classification have poor
generalization capability. This paper proposes two models- the pipeline model and the end-to-end model using Convolutional Neural Networks (CNN) and auto encoder–decoder network respectively. CNN architecture is implemented and tested by varying the number of convolutional layer, size
of the kernel as well as the number of kernels. Auto encoder–decoder performs pixel wise classification using two interconnected pathways for identifying the boundary of lumen-intima (LI) and media adventitia (MA). This helps in reconstruction of the segmented portion for measurement
of IMT. Both methods are tested using a dataset of 550 subjects. The results clearly indicate that end-to-end model has an edge over the pipeline model exhibiting lesser deviation between the automated measurement and the measurement made by the radiologist. The pipeline model however has
better segmentation accuracy when the size of the image used for training is small. The convolutional neural network with auto encoder–decoder proves robust through sparse representation, and faster learning with better generalization. Also, the experimental setup is analyzed by interconnecting
Tensor flow simulated result with Raspberry PI and the outcomes are analyzed.
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Affiliation(s)
- Sudha Subramaniam
- Research Scholar, Department of Electronics and Communication Engineering, K. S. Rangasamy College of Technology, Tiruchengode 637215, India
| | - K. B. Jayanthi
- School of Electrical Sciences, K. S. Rangasamy College of Technology, Tiruchengode 637215, India
| | - C. Rajasekaran
- Department of Electronics and Communication Engineering, K. S. Rangasamy College of Technology, Tiruchengode 637215, India
| | - C. Sunder
- Senior Consultant, Apollo Hospitals, Chennai 600081, India
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Elyas S, Adingupu D, Aizawa K, Casanova F, Gooding K, Fulford J, Mawson D, Gates PE, Shore AC, Strain D. Cerebral small vessel disease, systemic vascular characteristics and potential therapeutic targets. Aging (Albany NY) 2021; 13:22030-22039. [PMID: 34550097 PMCID: PMC8507297 DOI: 10.18632/aging.203557] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 08/31/2021] [Indexed: 12/05/2022]
Abstract
Introduction: Cerebral small vessel disease (SVD) is prevalent in the elderly population and is associated with increased risk of dementia, stroke and disability. Currently there are no clear targets or strategies for the treatment of cerebral SVD. We set out to identify modifiable vascular treatment targets. Patients and Methods: 112 participants with and without a history of CVD underwent macrovascular, microvascular and endothelial function tests and an MRI head scan. Results: Increased carotid intima media thickness and carotid-femoral pulse wave velocity were associated with cerebral WMH (β=1·1 p=0·001 and β=1·66, p<0·0001 respectively). Adjusted cerebral resistance index (p=0·03) and brachial flow mediated dilation time to peak (p=0·001) were associated with the severity of cerebral WMH independent of age and sex. Post occlusive reactive hyperaemia time as a measure of microvascular reactivity was associated with WMH after adjustment for age and sex (p=0·03). Ankle Brachial Pressure Index and urinary albumin excretion rate predicted the severity of cerebral WMH (p=0·02 and 0·01 respectively). Age and hypertension were the most important risk factors for WMH severity (p< 0·0001). Discussion: In addition to hypertension, microalbuminuria, arterial stiffness, vascular reactivity and cerebrovascular resistance could be potential treatment targets to halt the development or progression of cerebral SVD.
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Affiliation(s)
- Salim Elyas
- Institute of Biomedical and Clinical Science and NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter EX2 5AX, UK.,Academic Department of Healthcare for Older People, Royal Devon and Exeter NHS Foundation Trust, Exeter EX2 5DW, UK
| | - Damilola Adingupu
- Institute of Biomedical and Clinical Science and NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter EX2 5AX, UK
| | - Kunihiko Aizawa
- Institute of Biomedical and Clinical Science and NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter EX2 5AX, UK
| | - Francesco Casanova
- Institute of Biomedical and Clinical Science and NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter EX2 5AX, UK
| | - Kim Gooding
- Institute of Biomedical and Clinical Science and NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter EX2 5AX, UK
| | - Jonathan Fulford
- Institute of Biomedical and Clinical Science and NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter EX2 5AX, UK
| | - Dave Mawson
- Institute of Biomedical and Clinical Science and NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter EX2 5AX, UK
| | - Phillip E Gates
- Institute of Biomedical and Clinical Science and NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter EX2 5AX, UK
| | - Angela C Shore
- Institute of Biomedical and Clinical Science and NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter EX2 5AX, UK
| | - David Strain
- Institute of Biomedical and Clinical Science and NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter EX2 5AX, UK.,Academic Department of Healthcare for Older People, Royal Devon and Exeter NHS Foundation Trust, Exeter EX2 5DW, UK
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8
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Effect of the internal carotid artery degree of stenosis on wall and plaque distensibility. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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9
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Biswas M, Saba L, Omerzu T, Johri AM, Khanna NN, Viskovic K, Mavrogeni S, Laird JR, Pareek G, Miner M, Balestrieri A, Sfikakis PP, Protogerou A, Misra DP, Agarwal V, Kitas GD, Kolluri R, Sharma A, Viswanathan V, Ruzsa Z, Nicolaides A, Suri JS. A Review on Joint Carotid Intima-Media Thickness and Plaque Area Measurement in Ultrasound for Cardiovascular/Stroke Risk Monitoring: Artificial Intelligence Framework. J Digit Imaging 2021; 34:581-604. [PMID: 34080104 PMCID: PMC8329154 DOI: 10.1007/s10278-021-00461-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 03/19/2021] [Accepted: 05/04/2021] [Indexed: 02/06/2023] Open
Abstract
Cardiovascular diseases (CVDs) are the top ten leading causes of death worldwide. Atherosclerosis disease in the arteries is the main cause of the CVD, leading to myocardial infarction and stroke. The two primary image-based phenotypes used for monitoring the atherosclerosis burden is carotid intima-media thickness (cIMT) and plaque area (PA). Earlier segmentation and measurement methods were based on ad hoc conventional and semi-automated digital imaging solutions, which are unreliable, tedious, slow, and not robust. This study reviews the modern and automated methods such as artificial intelligence (AI)-based. Machine learning (ML) and deep learning (DL) can provide automated techniques in the detection and measurement of cIMT and PA from carotid vascular images. Both ML and DL techniques are examples of supervised learning, i.e., learn from "ground truth" images and transformation of test images that are not part of the training. This review summarizes (1) the evolution and impact of the fast-changing AI technology on cIMT/PA measurement, (2) the mathematical representations of ML/DL methods, and (3) segmentation approaches for cIMT/PA regions in carotid scans based for (a) region-of-interest detection and (b) lumen-intima and media-adventitia interface detection using ML/DL frameworks. AI-based methods for cIMT/PA segmentation have emerged for CVD/stroke risk monitoring and may expand to the recommended parameters for atherosclerosis assessment by carotid ultrasound.
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Affiliation(s)
| | - Luca Saba
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), Cagliari, Italy
| | - Tomaž Omerzu
- Department of Neurology, University Medical Centre Maribor, Maribor, Slovenia
| | - Amer M Johri
- Department of Medicine, Division of Cardiology, Queen's University, Kingston, ON, Canada
| | - Narendra N Khanna
- Department of Cardiology, Indraprastha APOLLO Hospitals, New Delhi, India
| | | | - Sophie Mavrogeni
- Cardiology Clinic, Onassis Cardiac Surgery Center, Athens, Greece
| | - John R Laird
- Heart and Vascular Institute, Adventist Health St. Helena, St Helena, CA, USA
| | - Gyan Pareek
- Minimally Invasive Urology Institute, Brown University, Providence, Rhode Island, USA
| | - Martin Miner
- Men's Health Center, Miriam Hospital Providence, Rhode Island, USA
| | - Antonella Balestrieri
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), Cagliari, Italy
| | - Petros P Sfikakis
- Rheumatology Unit, National Kapodistrian University of Athens, Athens, Greece
| | | | | | - Vikas Agarwal
- Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India
| | - George D Kitas
- Academic Affairs, Dudley Group NHS Foundation Trust, Dudley, UK
- Arthritis Research UK Epidemiology Unit, Manchester University, Manchester, UK
| | | | - Aditya Sharma
- Division of Cardiovascular Medicine, University of Virginia, Charlottesville, VA, USA
| | - Vijay Viswanathan
- MV Hospital for Diabetes and Professor M Viswanathan Diabetes Research Centre, Chennai, India
| | - Zoltan Ruzsa
- Invasive Cardiology Division, University of Szeged, Budapest, Hungary
| | - Andrew Nicolaides
- Vascular Screening and Diagnostic Centre, University of Nicosia Medical School, Nicosia, Cyprus
| | - Jasjit S Suri
- Stroke Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA, 95661, USA.
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Dieden A, Malan L, Mels CM, Lammertyn L, Wentzel A, Nilsson PM, Gudmundsson P, Jujic A, Magnusson M. Exploring biomarkers associated with deteriorating vascular health using a targeted proteomics chip: The SABPA study. Medicine (Baltimore) 2021; 100:e25936. [PMID: 34011069 PMCID: PMC8137024 DOI: 10.1097/md.0000000000025936] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 04/16/2021] [Indexed: 01/05/2023] Open
Abstract
In this observational study, by the use of a multiplex proteomic platform, we aimed to explore associations between 92 targeted proteins involved in cardiovascular disease and/or inflammation, and phenotypes of deteriorating vascular health, with regards to ethnicity.Proteomic profiling (92 proteins) was carried out in 362 participants from the Sympathetic activity and Ambulatory Blood Pressure in Africans (SABPA) study of black and white African school teachers (mean age 44.7 ± 9.9 years, 51.9% women, 44.5% Black Africans, 9.9% with known cardiovascular disease). Three proteins with <15% of samples below detectable limits were excluded from analyses. Associations between multiple proteins and prevalence of hypertension as well as vascular health [Carotid intima-media thickness (cIMT) and pulse wave velocity (PWV)] measures were explored using Bonferroni-corrected regression models.Bonferroni-corrected significant associations between 89 proteins and vascular health markers were further adjusted for clinically relevant co-variates. Hypertension was associated with growth differentiation factor 15 (GDF-15) and C-X-C motif chemokine 16 (CXCL16). cIMT was associated with carboxypeptidase A1 (CPA1), C-C motif chemokine 15 (CCL15), chitinase-3-like protein 1 (CHI3L1), scavenger receptor cysteine-rich type 1 protein M130 (CD163) and osteoprotegerin, whereas PWV was associated with GDF15, E-selectin, CPA1, fatty acid-binding protein 4 (FABP4), CXCL16, carboxypeptidase B (CPB1), and tissue-type plasminogen activator. Upon entering ethnicity into the models, the associations between PWV and CPA1, CPB1, GDF-15, FABP4, CXCL16, and between cIMT and CCL-15, remained significant.Using a multiplex proteomic approach, we linked phenotypes of vascular health with several proteins. Novel associations were found between hypertension, PWV or cIMT and proteins linked to inflammatory response, chemotaxis, coagulation or proteolysis. Further, we could reveal whether the associations were ethnicity-dependent or not.
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Affiliation(s)
- Anna Dieden
- Department of Biomedical Science, Malmö University
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Biofilms- Research Centre for Biointerfaces, Malmö University, Sweden
| | | | - Catharina M.C. Mels
- Hypertension in Africa Research Team (HART)
- MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Leandi Lammertyn
- Hypertension in Africa Research Team (HART)
- MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | | | | | - Petri Gudmundsson
- Department of Biomedical Science, Malmö University
- Biofilms- Research Centre for Biointerfaces, Malmö University, Sweden
| | - Amra Jujic
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Cardiology, Skåne University Hospital, Malmö
| | - Martin Magnusson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Hypertension in Africa Research Team (HART)
- Department of Cardiology, Skåne University Hospital, Malmö
- Wallenberg Center for Molecular Medicine, Lund University, Sweden
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Qian C, Su E, Yang X. Segmentation of the Common Carotid Intima-Media Complex in Ultrasound Images Using 2-D Continuous Max-Flow and Stacked Sparse Auto-encoder. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:3104-3124. [PMID: 32888749 DOI: 10.1016/j.ultrasmedbio.2020.07.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 07/14/2020] [Accepted: 07/20/2020] [Indexed: 06/11/2023]
Abstract
The intima-media thickness (IMT) of a common carotid artery in an ultrasound image is considered an important indicator of the onset of atherosclerosis. However, it is challenging to segment the intima-media complex (IMC) directly in ultrasound images. This study proposes a fully automatic method to segment the IMC on longitudinal B-mode ultrasound images. Our method consists of two stages: (i) extraction of the region of interest with a continuous max-flow algorithm and region-of-interest reconstruction using a stacked sparse auto-encoder model, and (ii) IMC segmentation using a trained random forest classifier. The proposed method has been tested on three databases from three different imaging centres, comprising a total of 228 ultrasound images of the common carotid artery. On the three databases, our method yields mean absolute errors of 0.028 ± 0.016 mm, 0.579 ± 0.288 pixel and 0.582 ± 0.341 pixel; polyline distance (PD) measures of 0.026 ± 0.017 mm, 0.657 ± 0.275 pixel and 0.731 ± 0:282 pixel; Hausdorff distance measures of 0.249 ± 0.101 mm, 4.760 ± 1.085 pixels and 5.825 ± 2.059 pixels; and correlation coefficients of 95.19%, 93.79%, and 98.96%, respectively. These results indicate that the proposed method performs well in segmentation of the IMC and measurement of the IMT.
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Affiliation(s)
- Chunjun Qian
- Department of Intelligent Development Platform, Laundry Division of Midea Group, Wuxi, Jiangsu, China; School of Science, Nanjing University of Science and Technology, Nanjing, Jiangsu, China
| | - Enjie Su
- Chinese Medical Hospital of Wujin, Changzhou, Jiangsu, China
| | - Xiaoping Yang
- Department of Mathematics, Nanjing University, Nanjing, Jiangsu, China.
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12
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Associations between carotid artery longitudinal wall motion and arterial stiffness indicators in young children. Atherosclerosis 2019; 287:64-69. [DOI: 10.1016/j.atherosclerosis.2019.06.895] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 05/23/2019] [Accepted: 06/05/2019] [Indexed: 01/19/2023]
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13
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Zhang L, Huang J, Liu L. Improved Deep Learning Network Based in combination with Cost-sensitive Learning for Early Detection of Ovarian Cancer in Color Ultrasound Detecting System. J Med Syst 2019; 43:251. [PMID: 31254110 DOI: 10.1007/s10916-019-1356-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 05/22/2019] [Indexed: 12/29/2022]
Abstract
With the development of theories and technologies in medical imaging, most of the tumors can be detected in the early stage. However, the nature of ovarian cysts lacks accurate judgement, leading to that many patients with benign nodules still need Fine Needle Aspiration (FNA) biopsies or surgeries, increasing the physical pain and mental pressure of patients as well as unnecessary medical health care costs. Therefore, we present an image diagnosis system for classifying the ovarian cysts in color ultrasound images, which novelly applies the image features fused by both high-level features from deep learning network and low-level features from texture descriptor. Firstly, the ultrasound images are enhanced to improve the quality of training data set and the rotation invariant uniform local binary pattern (ULBP) features are extracted from each of the images as the low-level texture features. Then the high-level deep features extracted by the fine-tuned GoogLeNet neural network and the low-level ULBP features are normalized and cascaded as one fusion feature that can represent both the semantic context and the texture patterns distributed in the image. Finally, the fusion features are input to the Cost-sensitive Random Forest classifier to classify the images into "malignant" and "benign". The high-level features extracted by the deep neural network from the medical ultrasound image can reflect the visual features of the lesion region, while the low-level texture features can describe the edges, direction and distribution of intensities. Experimental results indicate that the combination of the two types of features can describe the differences between the lesion regions and other regions, and the differences between lesions regions of malignant and benign ovarian cysts.
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Affiliation(s)
- Lei Zhang
- The Ultrasound Centre, Tianjin central hospital of gynecology obstetrics, Tianjin, 300052, China
| | - Jian Huang
- The Ultrasound Centre, Tianjin central hospital of gynecology obstetrics, Tianjin, 300052, China
| | - Li Liu
- The Ultrasound Centre, Tianjin central hospital of gynecology obstetrics, Tianjin, 300052, China.
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Zhou Z, Shin J, Feng R, Hurst RT, Kendall CB, Liang J. Integrating Active Learning and Transfer Learning for Carotid Intima-Media Thickness Video Interpretation. J Digit Imaging 2019; 32:290-299. [PMID: 30402668 PMCID: PMC6456630 DOI: 10.1007/s10278-018-0143-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Cardiovascular disease (CVD) is the number one killer in the USA, yet it is largely preventable (World Health Organization 2011). To prevent CVD, carotid intima-media thickness (CIMT) imaging, a noninvasive ultrasonography method, has proven to be clinically valuable in identifying at-risk persons before adverse events. Researchers are developing systems to automate CIMT video interpretation based on deep learning, but such efforts are impeded by the lack of large annotated CIMT video datasets. CIMT video annotation is not only tedious, laborious, and time consuming, but also demanding of costly, specialty-oriented knowledge and skills, which are not easily accessible. To dramatically reduce the cost of CIMT video annotation, this paper makes three main contributions. Our first contribution is a new concept, called Annotation Unit (AU), which simplifies the entire CIMT video annotation process down to six simple mouse clicks. Our second contribution is a new algorithm, called AFT (active fine-tuning), which naturally integrates active learning and transfer learning (fine-tuning) into a single framework. AFT starts directly with a pre-trained convolutional neural network (CNN), focuses on selecting the most informative and representative AU s from the unannotated pool for annotation, and then fine-tunes the CNN by incorporating newly annotated AU s in each iteration to enhance the CNN's performance gradually. Our third contribution is a systematic evaluation, which shows that, in comparison with the state-of-the-art method (Tajbakhsh et al., IEEE Trans Med Imaging 35(5):1299-1312, 2016), our method can cut the annotation cost by >81% relative to their training from scratch and >50% relative to their random selection. This performance is attributed to the several advantages derived from the advanced active, continuous learning capability of our AFT method.
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Affiliation(s)
- Zongwei Zhou
- Arizona State University, 13212 E Shea Blvd, Scottsdale, AZ 85259 USA
| | - Jae Shin
- Arizona State University, 13212 E Shea Blvd, Scottsdale, AZ 85259 USA
| | - Ruibin Feng
- Arizona State University, 13212 E Shea Blvd, Scottsdale, AZ 85259 USA
| | - R. Todd Hurst
- Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ 85259 USA
| | | | - Jianming Liang
- Arizona State University, 13212 E Shea Blvd, Scottsdale, AZ 85259 USA
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15
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SMITHA B, JOSEPH KPAUL. A NEW APPROACH FOR CLASSIFICATION OF ATHEROSCLEROSIS OF COMMON CAROTID ARTERY FROM ULTRASOUND IMAGES. J MECH MED BIOL 2019. [DOI: 10.1142/s0219519419400013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background and objectives: The diagnosis of carotid atherosclerosis is of vital importance, as this cardiovascular disease may cause myocardial infarction. One-third of deaths in the world occur due to myocardial infarction, commonly known as heart attack. Atherosclerosis is deposition of plaque in artery wall. It could be detected from the features of intima-media complex of the artery wall. This study proposes a new classification approach to distinguish between symptomatic and asymptomatic plaques using non-invasive carotid B-mode ultrasound images. These two types of plaques have diverse impacts on human life. In the first condition, slowly plaque formation reaches life-threatening condition and the second condition is acute in nature. Hence treatment protocol is to be decided based on the type of plaque. Methods: To locate the intima-media-complex region, the images are segmented using snake-based segmentation algorithm. Several features are extracted using fixed size blocks selected from the segmented region using gray-level co-occurrence matrix. Finally classification is performed using support vector machine. Results: The performance shows improvement in accuracy using lesser number of features than previous works. The reduction in feature size is achieved by incorporating segmentation in the pre-processing stage. In the classifier, 10-fold cross-validation protocol is used for training and testing and an accuracy of 100% is obtained. Conclusion: This proposed technique could work as an adjunct tool in quick decision-making for cardiologists and radiologists.
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Affiliation(s)
- B. SMITHA
- Department of Electrical Engineering, National Institute of Technology, Calicut 673601, Kerala, India
| | - K. PAUL JOSEPH
- Department of Electrical Engineering, National Institute of Technology, Calicut 673601, Kerala, India
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16
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Kumar PK, Araki T, Rajan J, Laird JR, Nicolaides A, Suri JS. State-of-the-art review on automated lumen and adventitial border delineation and its measurements in carotid ultrasound. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2018; 163:155-168. [PMID: 30119850 DOI: 10.1016/j.cmpb.2018.05.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 04/29/2018] [Accepted: 05/09/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND AND OBJECTIVE Accurate, reliable, efficient, and precise measurements of the lumen geometry of the common carotid artery (CCA) are important for (a) managing the progression/regression of atherosclerotic build-up and (b) the risk of stroke. The image-based degree of stenosis in the carotid artery and the plaque burden can be predicted using the automated carotid lumen diameter (LD)/inter-adventitial diameter (IAD) measurements from B-mode ultrasound images. The objective of this review is to present the state-of-the-art methods and systems for the measurement of LD/IAD in CCA based on automated or semi-automated strategies. Further, the performance of these systems is compared based on various metrics for its measurements. METHODS The automated algorithms proposed for the segmentation of carotid lumen are broadly classified into two different categories as: region-based and boundary-based. These techniques are discussed in detail specifying their pros and cons. Further, we discuss the challenges encountered in the segmentation process along with its quantitative assessment. Lastly, we present stenosis quantification and risk stratification strategies. RESULTS Even though, we have found more boundary-based approaches compared to region-based approaches in the literature, however, the region-based strategy yield more satisfactory performance. Novel risk stratification strategies are presented. On a patient database containing 203 patients, 9 patients are identified as high risk patients, whereas 27 patients are identified as medium risk patients. CONCLUSIONS We have presented different techniques for the lumen segmentation of the common carotid artery from B-mode ultrasound images and measurement of lumen diameter and inter-adventitial diameter. We believe that the issue regarding boundary-based techniques can be compensated by taking regional statistics embedded with boundary-based information.
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Affiliation(s)
- P Krishna Kumar
- Department of Computer Science and Engineering, National Institute of Technology Calicut, Kerala, India
| | - Tadashi Araki
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Jeny Rajan
- Department of Computer Science and Engineering, National Institute of Technology Karnataka, Surathkal, India
| | - John R Laird
- Heart and Vascular Institute, Adventist Health, St. Helena, CA, USA
| | | | - Jasjit S Suri
- Stroke Monitoring Division, AtheroPoint, Roseville, CA, USA; Department of Electrical Engineering, University of Idaho (Affl.), ID, USA.
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17
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Zhao S, Gao Z, Zhang H, Xie Y, Luo J, Ghista D, Wei Z, Bi X, Xiong H, Xu C, Li S. Robust Segmentation of Intima–Media Borders With Different Morphologies and Dynamics During the Cardiac Cycle. IEEE J Biomed Health Inform 2018; 22:1571-1582. [DOI: 10.1109/jbhi.2017.2776246] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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18
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S. S, K. B. J, C. R, Madian N, T. S. Convolutional Neural Network for Segmentation and Measurement of Intima Media Thickness. J Med Syst 2018; 42:154. [DOI: https:/doi.org/10.1007/s10916-018-1001-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 06/21/2018] [Indexed: 08/30/2023]
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19
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Convolutional Neural Network for Segmentation and Measurement of Intima Media Thickness. J Med Syst 2018; 42:154. [DOI: 10.1007/s10916-018-1001-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 06/21/2018] [Indexed: 12/28/2022]
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20
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The contribution of obesity to carotid atherosclerotic plaque burden in a general population sample in Norway: The Tromsø Study. Atherosclerosis 2018; 273:15-20. [PMID: 29665456 DOI: 10.1016/j.atherosclerosis.2018.04.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 03/16/2018] [Accepted: 04/11/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIMS Few studies have investigated the association of different measures of adiposity with carotid plaque. We aimed to investigate and compare the associations of four measures of adiposity: body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) with the presence of carotid plaque and total plaque area (TPA) in the right carotid artery. METHODS We included 4906 individuals aged 31-88 years who participated in a population-based study with ultrasonography of the right carotid artery. Adiposity measures were converted to sex-specific SD units to allow comparison of effect sizes. TPA was log transformed due to its skewed distribution. Logistic and linear regression models were used respectively to investigate the association of each adiposity measure with the presence of plaque and with log-transformed TPA. Estimates were adjusted for potential confounders and mediators such as blood pressure and lipids. RESULTS After adjustment for age, sex, smoking, and education level, there was strong evidence of an association between all adiposity measures and log-transformed TPA, whereas only WHR was weakly associated with presence of plaque. WHR showed the largest adjusted effect size for both log-transformed TPA (beta 0.055, 95%CI 0.028-0.081) and the presence of plaque (OR 1.07, 95%CI 1.01-1.15). Adjustment for mediators led to appreciable attenuation of observed effects. CONCLUSIONS Adiposity is more consistently associated with extent of plaque burden than with whether an individual does or does not have any plaque. There was evidence that established biomarkers mediate much of this association. Abdominal adiposity appears to show the strongest effect.
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21
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Petrini J, Ring M, Franco-Cereceda A, Caidahl K, Eriksson MJ. Aortic versus carotid intima-media thickness and impact of aortic valve disease. Clin Physiol Funct Imaging 2018; 38:895-902. [PMID: 29345099 DOI: 10.1111/cpf.12502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 12/13/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS Intima-media thickness is a marker for atherosclerosis but is also influenced by shear stress and flow. We evaluated the relation between intima-media thickness of the descending aorta (AoIMT) and the common carotid artery (CIMT) in patients with and without severe aortic valve disease (sAVD). METHODS A total of 310 patients (233 with sAVD, 77 without) were examined with regard to AoIMT and CIMT using transesophageal echocardiography and carotid ultrasound, respectively, before valvular and/or aortic surgery. Digitally stored B-mode images were used for semiautomatic AoIMT and CIMT measurements. RESULTS There were no significant differences in patients with or without sAVD with regard to AoIMT (1·35 ± 0·31 vs. 1·35 ± 0·33 mm) or CIMT (0·80 ± 0·15 vs. 0·78 ± 0·16 mm). The correlations between AoIMT and CIMT were r = 0·29 in patients with and r = 0·51 in patients without sAVD, and the difference between these correlations was significant (P<0·05). In multivariate regression, age was the main determinant for AoIMT and CIMT in both groups, further in sAVD, the aortic mean pressure gradient (Pmean ) was a determinant of AoIMT, but not of CIMT. CONCLUSIONS The correlation between CIMT and AoIMT is weaker in patients with sAVD compared to those without sAVD. Pmean is also a significant predictor of AoIMT, but not of CIMT. This implies that, in addition to the atherosclerotic process, turbulent aortic flow or altered blood flow helicity created by large stroke volumes and diastolic flow reversal or high-velocity jets, affect the intima-media of the descending aorta and common carotid artery differently.
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Affiliation(s)
- Johan Petrini
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Physiology, Södersjukhuset, Stockholm, Sweden
| | - Margareta Ring
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
| | - Anders Franco-Cereceda
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Cardiothoracic Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Kenneth Caidahl
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden.,Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Maria J Eriksson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
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22
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Hu KC, Wu MS, Chu CH, Wang HY, Lin SC, Po HL, Bair MJ, Liu CC, Su TH, Chen CL, Liu CJ, Shih SC. Hyperglycemia combined Helicobacter pylori infection increases risk of synchronous colorectal adenoma and carotid artery plaque. Oncotarget 2017; 8:108655-108664. [PMID: 29312558 PMCID: PMC5752471 DOI: 10.18632/oncotarget.22094] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 09/23/2017] [Indexed: 01/06/2023] Open
Abstract
Background Cardiovascular disease and colorectal cancer have severe consequences to human health and may occur simultaneously or sequentially. Carotid artery plaque is a predictor of cardiovascular disease, and colorectal adenoma is a premalignant lesion of colorectal cancer. We investigated the core risk factors of carotid artery plaque and colorectal adenoma. Results In total, 2361 subjects were enrolled. In multivariate analysis, age ≥ 60 years, male sex, BMI > 27, LDL > 130 mg/dL, HbA1c ≥ 6.5%, hs-CRP > 0.3 mg/L and H. pylori infection were independent risk factors for synchronous colorectal adenoma and carotid artery plaque formation. In the H. pylori-positive and -negative groups, the proportions and odds ratio (OR) for synchronous colon adenoma and carotid artery plaque increased with increasing HbA1c. OR for synchronous colon adenoma and carotid artery plaque was significantly higher in the participants with HbA1c levels of 5.7%–6.4% and HbA1c ≥ 6.5% than in those with normal HbA1c in the H. pylori-negative group. The OR was more significant increased for H. pylori-positive patients when HbA1c level ≥ 6.5% was 15.87 (95% CI 8.661–29.082, p < 0.0001). Materials and Methods The records of 4669 subjects aged > 40 years who underwent bidirectional gastrointestinal endoscopy and carotid artery ultrasound examination on the same day or within 12 months of endoscopy examination from January 2006 to December 2015 were reviewed. All subjects had a gastric biopsy specimen tested for Helicobacter pylori. Conclusions Hyperglycemia combined with H. pylori infection was an increased risk factor for synchronous colorectal adenoma and carotid artery plaque formation. Diabetes control and H. pylori eradication may be warranted in higher prevalence areas.
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Affiliation(s)
- Kuang-Chun Hu
- Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan.,Healthy Evaluation Center, MacKay Memorial Hospital, Taipei, Taiwan.,MacKay Medicine, Nursing and Management College, Taipei, Taiwan.,Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.,MacKay Medical College, Taipei, Taiwan
| | - Ming-Shiang Wu
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Cheng-Hsin Chu
- Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan.,MacKay Medicine, Nursing and Management College, Taipei, Taiwan
| | - Horng-Yuan Wang
- Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan.,Healthy Evaluation Center, MacKay Memorial Hospital, Taipei, Taiwan.,MacKay Medicine, Nursing and Management College, Taipei, Taiwan
| | - Shee-Chan Lin
- Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan.,MacKay Medicine, Nursing and Management College, Taipei, Taiwan
| | - Helen L Po
- Department of Neurology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Ming-Jong Bair
- Gastroenterology Division, Department of Internal Medicine, MacKay Memorial Hospital, Taitung Branch, Taiwan
| | - Chuan-Chuan Liu
- Healthy Evaluation Center, MacKay Memorial Hospital, Taipei, Taiwan
| | - Tung-Hung Su
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chi-Ling Chen
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chun-Jen Liu
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Shou-Chuan Shih
- Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan.,Healthy Evaluation Center, MacKay Memorial Hospital, Taipei, Taiwan.,MacKay Medicine, Nursing and Management College, Taipei, Taiwan.,MacKay Medical College, Taipei, Taiwan
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23
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Carotid Intima-Media Thickness as a Cardiovascular Risk Factor and Imaging Pathway of Atherosclerosis. Crit Pathw Cardiol 2017; 15:152-160. [PMID: 27846007 DOI: 10.1097/hpc.0000000000000087] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Assessment of carotid intima-media thickness (IMT) has emerged as a simple and noninvasive technique for measuring atherosclerotic burden. Although serum biomarkers have been linked to the risk of developing atherosclerosis, carotid IMT has the theoretical advantage of directly visualizing a final consequence of the disease itself, namely atherosclerosis in the vessel wall. The current widespread application of carotid IMT measurements has been based on the validity, standardization, and reproducibility of the measurement and the evidence that an increased carotid IMT can be regarded as an attractive biomarker of atherosclerosis and of increased cardiovascular risk, potentially useful as a therapeutic target in those at increased cardiovascular risk. The utilization of carotid IMT measurements as a surrogate end point in clinical trials evaluating a specific drug intervention may result in considerably smaller efforts and costs than when using a hard end point such as myocardial infarction, stroke, or death. In addition, the use of carotid IMT measurement as a screening tool in clinical practice in association with traditional risk factors may improve risk classification and decisions regarding therapeutic interventions. However, although carotid IMT may be correlated with clinical outcomes, changes in surrogate end points over time that result from a particular therapy may not necessarily be predictive of future cardiovascular events. Therefore, it is necessary to perform more clinical studies to clearly define the relationship between the modifications in carotid IMT and the changes in cardiovascular events. In an era of economic burden, when there is a clear combination of limited resources with high expense of innovation in drug development, carotid IMT represents a reasonable, worthwhile surrogate trial end point with a history of nearly 30 years of technical progress and clinical research. Current data strongly suggest that carotid IMT will continue to successfully be used as a valuable tool in clinical atherosclerosis research.
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Patel AK, Suri HS, Singh J, Kumar D, Shafique S, Nicolaides A, Jain SK, Saba L, Gupta A, Laird JR, Giannopoulos A, Suri JS. A Review on Atherosclerotic Biology, Wall Stiffness, Physics of Elasticity, and Its Ultrasound-Based Measurement. Curr Atheroscler Rep 2017; 18:83. [PMID: 27830569 DOI: 10.1007/s11883-016-0635-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Functional and structural changes in the common carotid artery are biomarkers for cardiovascular risk. Current methods for measuring functional changes include pulse wave velocity, compliance, distensibility, strain, stress, stiffness, and elasticity derived from arterial waveforms. The review is focused on the ultrasound-based carotid artery elasticity and stiffness measurements covering the physics of elasticity and linking it to biological evolution of arterial stiffness. The paper also presents evolution of plaque with a focus on the pathophysiologic cascade leading to arterial hardening. Using the concept of strain, and image-based elasticity, the paper then reviews the lumen diameter and carotid intima-media thickness measurements in combined temporal and spatial domains. Finally, the review presents the factors which influence the understanding of atherosclerotic disease formation and cardiovascular risk including arterial stiffness, tissue morphological characteristics, and image-based elasticity measurement.
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Affiliation(s)
- Anoop K Patel
- Department of Computer Engineering, NIT, Kurukshetra, India
| | | | - Jaskaran Singh
- Department of Computer Engineering, NIT, Kurukshetra, India
| | - Dinesh Kumar
- Point-of-Care Devices, Global Biomedical Technologies, Inc., Roseville, CA, USA
| | | | | | - Sanjay K Jain
- Department of Computer Engineering, NIT, Kurukshetra, India
| | - Luca Saba
- Department of Radiology, University of Cagliari, Cagliari, Italy
| | - Ajay Gupta
- Radiology Department, Brain and Mind Research Institute, Weill Cornell Medical College, New York, NY, USA
| | - John R Laird
- UC Davis Vascular Center, University of California, Davis, CA, USA
| | | | - Jasjit S Suri
- Vascular Diagnostic Center, University of Cyprus, Nicosia, Cyprus. .,Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA, USA. .,Department of Electrical Engineering, University of Idaho (Affl.), Moscow, ID, USA. .,Diagnosis and Stroke Monitoring Division, AtheroPoint™, Roseville, CA, USA.
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25
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Ungru K, Jiang X. Dynamic Programming Based Segmentation in Biomedical Imaging. Comput Struct Biotechnol J 2017; 15:255-264. [PMID: 28289536 PMCID: PMC5338725 DOI: 10.1016/j.csbj.2017.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 02/06/2017] [Accepted: 02/07/2017] [Indexed: 10/25/2022] Open
Abstract
Many applications in biomedical imaging have a demand on automatic detection of lines, contours, or boundaries of bones, organs, vessels, and cells. Aim is to support expert decisions in interactive applications or to include it as part of a processing pipeline for automatic image analysis. Biomedical images often suffer from noisy data and fuzzy edges. Therefore, there is a need for robust methods for contour and line detection. Dynamic programming is a popular technique that satisfies these requirements in many ways. This work gives a brief overview over approaches and applications that utilize dynamic programming to solve problems in the challenging field of biomedical imaging.
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Affiliation(s)
- Kathrin Ungru
- Department of Mathematics and Computer Science, University of Münster, Münster, Germany
| | - Xiaoyi Jiang
- Department of Mathematics and Computer Science, University of Münster, Münster, Germany; Cluster of Excellence EXC 1003, Cells in Motion, Münster, Germany
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26
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Lind L, Carlsson AC, Siegbahn A, Sundström J, Ärnlöv J. Impact of physical activity on cardiovascular status in obesity. Eur J Clin Invest 2017; 47:167-175. [PMID: 28036119 DOI: 10.1111/eci.12722] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 12/28/2016] [Indexed: 01/04/2023]
Abstract
BACKGROUND We have recently shown that being physically active (PA) counteracts, but not eliminates the increased risk of future cardiovascular disease in overweight and obese subjects. To investigate this further, we studied the impact of being normal weight, overweight and obese on multiple markers of subclinical cardiovascular disease in relation to physical activity. MATERIALS AND METHODS At age 70, 1016 subjects were investigated in the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study. Being PA was defined as performing regular heavy exercise (self-reported). According to body mass index (BMI)/PA groups, the participants were categorized as PA/normal weight (BMI < 25 kg/m2 , n = 104), non-PA/normal weight (n = 234), PA/overweight (BMI 25-29·9 kg/m2 , n = 133), non-PA/overweight (n = 295), PA/obese (BMI ≥ 30 kg/m2 , n = 54) and non-PA/obese (n = 169). Several different measurements of endothelial reactivity and arterial compliance (plethysmography and ultrasound), cartotid artery atherosclerosis and echocardiography were performed, and seven markers of coagulation/fibrinolysis were measured. RESULTS Physically active subjects with obesity showed impaired vasoreactivity in the forearm resistance vessels, increased left ventricular mass and impaired left ventricular systolic and diastolic functions, together with impaired coagulation/fibrinolysis when compared to PA/normal-weight subjects (P < 0·05 to <0·001). The majority of these disturbances were seen also in PA/overweight subjects when compared to PA/normal-weight subjects (P < 0·05 to <0·001). CONCLUSIONS Our data provide additional support for the notion that an increased level of self-reported physical activity does not fully eliminate the deleterious cardiovascular consequences associated with overweight and obesity.
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Affiliation(s)
- Lars Lind
- Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden
| | - Axel C Carlsson
- Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden.,Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Agneta Siegbahn
- Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden
| | - Johan Sundström
- Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden
| | - Johan Ärnlöv
- Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden.,Department of Health and Social Sciences, Dalarna University, Falun, Sweden
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Choi HL, Au JS, MacDonald MJ. Carotid extra-media thickness increases with age, but is not related to arterial stiffness in adults. Artery Res 2017. [DOI: 10.1016/j.artres.2017.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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28
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Zahnd G, Kapellas K, van Hattem M, van Dijk A, Sérusclat A, Moulin P, van der Lugt A, Skilton M, Orkisz M. A Fully-Automatic Method to Segment the Carotid Artery Layers in Ultrasound Imaging: Application to Quantify the Compression-Decompression Pattern of the Intima-Media Complex During the Cardiac Cycle. ULTRASOUND IN MEDICINE & BIOLOGY 2017; 43:239-257. [PMID: 27742139 DOI: 10.1016/j.ultrasmedbio.2016.08.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 08/05/2016] [Accepted: 08/12/2016] [Indexed: 06/06/2023]
Abstract
The aim of this study was to introduce and evaluate a contour segmentation method to extract the interfaces of the intima-media complex in carotid B-mode ultrasound images. The method was applied to assess the temporal variation of intima-media thickness during the cardiac cycle. The main methodological contribution of the proposed approach is the introduction of an augmented dimension to process 2-D images in a 3-D space. The third dimension, which is added to the two spatial dimensions of the image, corresponds to the tentative local thickness of the intima-media complex. The method is based on a dynamic programming scheme that runs in a 3-D space generated with a shape-adapted filter bank. The optimal solution corresponds to a single medial axis representation that fully describes the two anatomical interfaces of the arterial wall. The method is fully automatic and does not require any input from the user. The method was trained on 60 subjects and validated on 184 other subjects from six different cohorts and four different medical centers. The arterial wall was successfully segmented in all analyzed images (average pixel size = 57 ± 20 mm), with average segmentation errors of 47 ± 70 mm for the lumen-intima interface, 55 ± 68 mm for the media-adventitia interface and 66 ± 90 mm for the intima-media thickness. The amplitude of the temporal variations in IMT during the cardiac cycle was significantly higher in the diseased population than in healthy volunteers (106 ± 48 vs. 86 ± 34 mm, p = 0.001). The introduced framework is a promising approach to investigate an emerging functional parameter of the arterial wall by assessing the cyclic compression-decompression pattern of the tissues.
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Affiliation(s)
- Guillaume Zahnd
- Biomedical Imaging Group Rotterdam, Departments of Radiology & Nuclear Medicine and Medical Informatics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
| | - Kostas Kapellas
- Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide, Adelaide, Australia
| | - Martijn van Hattem
- Department of Radiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Anouk van Dijk
- Department of Radiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - André Sérusclat
- Department of Radiology, Louis Pradel Hospital, Hospices Civils de Lyon, Université Lyon 1, Lyon, France
| | - Philippe Moulin
- Department of Endocrinology, Louis Pradel Hospital, Hospices Civils de Lyon, Université Lyon 1, Lyon, France
| | - Aad van der Lugt
- Department of Radiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Michael Skilton
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, Australia
| | - Maciej Orkisz
- Univ Lyon, INSA-Lyon, Université Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F-69621, Lyon, France
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Lind PM, Salihovic S, van Bavel B, Lind L. Circulating levels of perfluoroalkyl substances (PFASs) and carotid artery atherosclerosis. ENVIRONMENTAL RESEARCH 2017; 152:157-164. [PMID: 27771570 DOI: 10.1016/j.envres.2016.10.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 10/05/2016] [Accepted: 10/07/2016] [Indexed: 05/05/2023]
Abstract
BACKGROUND AND OBJECTIVE During recent years, some persistent organic pollutants (POPs) have been linked to atherosclerosis. One group of POPs, the poly- and perfluoroalkyl substances (PFASs) have not been investigated with regard to atherosclerotic plaques. METHODS Carotid artery atherosclerosis was assessed by ultrasound in 1016 subjects aged 70 years in the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study. Eight PFASs were detected in >75% of participants' plasma by ultra-performance liquid chromatography coupled to tandem mass spectrometry (UPLC-MS/MS). RESULTS No significant linear associations were observed between the PFASs and intima-media thickness (IMT), or the echogenicity in the intima-media complex (IM-GSM, a marker of lipid infiltration in the artery) when men and women were analyzed together. Neither was occurrence of carotid plaques related to PFASs levels. However, highly significant interactions were observed between some PFASs and sex regarding both IM-GSM and plaque prevalence. Perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), and perfluoroundecanoic acid (PFUnDA), were all related to IM-GSM in a positive fashion in women (p=0.002-0.003), while these relationships were negative in men. The levels of PFUnDA were significantly related to carotid plaque in women (OR 1.59, 95%CI 1.03-2.43, p=0.03), but not in men (OR 0.93, 95%CI 0.62-1.42, p=0.75). CONCLUSIONS In this cross-sectional study, a pronounced gender difference was observed regarding associations between some PFASs, especially the long-chain PFUnDA, and markers of atherosclerosis, with more pronounced relationships found in women. These findings suggest a sex-specific role for PFASs in atherosclerosis.
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Affiliation(s)
- P Monica Lind
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University Uppsala, Sweden.
| | - Samira Salihovic
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden; MTM Research Centre, School of Science and Technology, Örebro University, Örebro, Sweden.
| | - Bert van Bavel
- MTM Research Centre, School of Science and Technology, Örebro University, Örebro, Sweden.
| | - Lars Lind
- Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden.
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Menchón-Lara RM, Sancho-Gómez JL, Bueno-Crespo A. Early-stage atherosclerosis detection using deep learning over carotid ultrasound images. Appl Soft Comput 2016. [DOI: 10.1016/j.asoc.2016.08.055] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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31
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Cheng DC, Wu JF, Kao YH, Su CH, Liu SH. Accurate Measurement of Cross-Sectional Area of Femoral Artery on MRI Sequences of Transcontinental Ultramarathon Runners Using Optimal Parameters Selection. J Med Syst 2016; 40:260. [PMID: 27722979 DOI: 10.1007/s10916-016-0626-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Accepted: 09/26/2016] [Indexed: 11/25/2022]
Abstract
In clinics an accurate vessel segmentation method is important to quantize the vessel volume change with respect to time for artery elasticity measurement. This study proposes a modified version on 3D-expanded dynamic programming to find an optimal surface in a 3D matrix. The aim of this study is to discover the robustness against noises in measuring the cross-sectional area of the femoral artery on MRI datasets of ultra-endurance runners as accurately as possible. To do this, we use phantom images with different added noises and different image contrasts to find out the optimal parameters using grid search. The contrast between the vessel lumen and its background in phantom study is changed to simulate the real MRI dataset. We also add a plaque in phantom images to test the accuracy of the proposed algorithm in dealing pathologic cases. The phantom studies and grid search on selecting optimal parameters can offer an alternative way on parameter selection. In application to MRI, the accuracy is performed via comparisons between the manual tracings of experts and automated results. The mean relative error is 2.1 % ± 2.1 % on testing 11 MRI datasets (total 550 images). The phantom studies and grid search on selecting optimal parameters can offer an alternative way on parameter selection.
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Affiliation(s)
- Da-Chuan Cheng
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, 404, Taiwan
| | - Jhu-Fong Wu
- Department of Radiology, Chia-Yi Christian Hospital, Chia-Yi, 600, Taiwan
| | - Yi-Hsuan Kao
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Chun-Hung Su
- Institute of Medicine, School of Medicine, Chung-Shan Medical University, Taichung, 402, Taiwan
- Department of Internal Medicine, Chung-Shan Medical University Hospital, Taichung, 402, Taiwan
| | - Shing-Hong Liu
- Department of Computer Science and Information Engineering, Chaoyang University of Technology, Taichung, 413, Taiwan.
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Cheng DC, Chai SK, Xu SR, Liu SH. Elliptic Shape Prior Dynamic Programming for Accurate Vessel Segmentation in MRI Sequences with Automated Optimal Parameter Selection. J Med Biol Eng 2016. [DOI: 10.1007/s40846-016-0176-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Au JS, Ditor DS, MacDonald MJ, Stöhr EJ. Carotid artery longitudinal wall motion is associated with local blood velocity and left ventricular rotational, but not longitudinal, mechanics. Physiol Rep 2016; 4:4/14/e12872. [PMID: 27440745 PMCID: PMC4962076 DOI: 10.14814/phy2.12872] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Accepted: 06/28/2016] [Indexed: 11/24/2022] Open
Abstract
Recent studies have identified a predictable movement pattern of the common carotid artery wall in the longitudinal direction. While there is evidence that the magnitude of this carotid artery longitudinal wall motion (CALM) is sensitive to cardiovascular health status, little is known about the determinants of CALM. The purpose of this integrative study was to evaluate the contribution of left ventricular (LV) cardiac motion and local blood velocity to CALM. Simultaneous ultrasound measurements of CALM, common carotid artery mean blood velocity (MBV), and left ventricular motion were performed in ten young, healthy individuals (6 males; 22 ± 1 years). Peak anterograde CALM occurred at a similar time as peak MBV (18.57 ± 3.98% vs. 18.53 ± 2.81% cardiac cycle; t‐test: P = 0.94; ICC: 0.79, P < 0.01). The timing of maximum retrograde CALM displacement was different, but related, to both peak apical (41.00 ± 7.81% vs. 35.33 ± 5.79% cardiac cycle; t‐test: P < 0.01; ICC: 0.79, P < 0.01) and basal rotation (41.80 ± 6.12% vs. 37.30 ± 5.66% cardiac cycle; t‐test: P < 0.01; ICC: 0.74, P < 0.01) with peak cardiac displacements preceding peak CALM displacements in both cases. The association between basal rotation and retrograde CALM was further supported by strong correlations between their peak magnitudes (r = −0.70, P = 0.02), whereas the magnitude of septal longitudinal displacement was not associated with peak CALM (r = 0.11, P = 0.77). These results suggest that the rotational mechanical movement of the LV base may be closely associated with longitudinal mechanics in the carotid artery. This finding may have important implications for interpreting the complex relationship between ventricular and vascular function.
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Affiliation(s)
- Jason S Au
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - David S Ditor
- Department of Kinesiology, Brock University, St. Catharines, Ontario, Canada
| | | | - Eric J Stöhr
- Discipline of Physiology & Health, Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, Wales, UK
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la Cour JL, Andersen UB, Sørensen CH, Nygaard B, Jensen LT. Radioiodine Therapy Does Not Change the Atherosclerotic Burden of the Carotid Arteries. Thyroid 2016; 26:965-71. [PMID: 27117943 PMCID: PMC4939365 DOI: 10.1089/thy.2015.0538] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND AND AIM Atherosclerosis evolves or accelerates when arteries are exposed to ionizing radiation, both early and late after exposure. Radioiodine therapy of benign thyroid disease exposes the carotid arteries to 4-50 Gy, and may thereby increase the risk of atherosclerosis. Increased risk of cerebrovascular events has been reported after radioiodine therapy. This study aimed to examine whether atherosclerosis develops early or late after radioiodine therapy of benign thyroid disease. METHOD Patients treated for benign thyroid disorders (nontoxic goiter, adenoma, and hyperthyroidism) were examined with ultrasound for the main outcome, carotid intima media thickness (CIMT), and for plaque presence (plaque presence only in late damage). Signs of early damage from radioiodine were studied in 39 radioiodine-treated patients, who were examined before treatment and at 1, 3, 6, and 12 months after treatment. Late changes were studied in a cross-sectional case-control design, with radioiodine-treated patients as cases (n = 193) and patients treated with surgery as controls (n = 95). Data were analyzed with repeated measurement for longitudinal data, and with multivariate regression for cross-sectional data. Results were adjusted for age, sex, cholesterol, smoking status, known atherosclerotic disease, and body mass index. RESULTS No changes in CIMT were found in the patients followed prospectively for one year after treatment with radioactive iodine for benign thyroid disease (p = 0.58). In the study on late effects, there was no difference in CIMT (p = 0.25) or presence of plaques (p = 0.70) between those treated with radioactive iodine and those treated with surgery (9.8 and 5.6 years since treatment, respectively). Furthermore, the level of thyrotropin (TSH) did not influence these atherosclerosis markers. CONCLUSION No early changes in CIMT were detected in patients treated with radioactive iodine for benign thyroid disease. No signs of late effects of radioactive iodine on CIMT or plaque presence were found after 10 years of follow-up. The radiation to the carotid arteries by radioactive iodine therapy for benign thyroid disease may therefore have no or low effect on atherosclerotic burden of the carotid arteries in general.
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Affiliation(s)
- Jeppe Lerche la Cour
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University of Copenhagen, Glostrup, Denmark
| | - Ulrik Bjørn Andersen
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University of Copenhagen, Glostrup, Denmark
| | - Christian Hjort Sørensen
- Department of ENT, Head & Neck Surgery and Audiology, Rigshospitalet/Gentofte University Hospital of Copenhagen, Hellerup, Denmark
| | - Birte Nygaard
- Section of Endocrinology, Department of Medicine, University Hospital of Herlev, Herlev, Denmark
| | - Lars Thorbjørn Jensen
- Department of Clinical Physiology and Nuclear Medicine, University Hospital of Herlev, Herlev, Denmark
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Eikendal ALM, Groenewegen KA, Bots ML, Peters SAE, Uiterwaal CSPM, den Ruijter HM. Relation Between Adolescent Cardiovascular Risk Factors and Carotid Intima-Media Echogenicity in Healthy Young Adults: The Atherosclerosis Risk in Young Adults (ARYA) Study. J Am Heart Assoc 2016; 5:JAHA.115.002941. [PMID: 27172911 PMCID: PMC4889174 DOI: 10.1161/jaha.115.002941] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Background Echogenicity is an ultrasound measure that reflects arterial wall composition. In adult populations, lower carotid intima‐media echogenicity relates to an unfavorable cardiovascular risk burden yet appears to reflect a different aspect of arterial wall remodeling than carotid intima‐media thickness (CIMT). Since studies on carotid intima‐media echogenicity earlier in life are lacking, we investigated associations between adolescent cardiovascular risk factors and young adulthood carotid intima‐media echogenicity and compared this to CIMT. Methods and Results In 736 participants of the Atherosclerosis Risk in Young Adults study, information on adolescent anthropometrics, puberty stage, and systolic blood pressure (SBP) was available. In young adulthood, demographics, anthropometrics, and fasting plasma samples were collected. Common CIMT and echogenicity, quantified as gray‐scale median (GSM), were evaluated using B‐mode ultrasonography. Lower and higher GSM values, respectively, represented lower and higher echogenicity. Associations of adolescent body mass index and SBP with young adulthood GSM and CIMT were evaluated using linear regression analysis. Mean age was 13.5 years in adolescence and 28.4 years in young adulthood (difference: 14.9 years). After full adjustment, adolescent body mass index related to GSM (β=−1.62/SD; 95% CI: −2.79, −0.46; P=0.006), independent of CIMT. Adolescent SBP did not relate to GSM. Moreover, adolescent body mass index (β=8.06 μm/SD [95% CI: 4.12, 11.99], P<0.001) and SBP (β=4.69 μm/SD [95% CI: 0.84, 8.54], P=0.02) related to CIMT. Conclusions Adolescent body mass index related to GSM and CIMT in young adulthood; SBP only related to CIMT. Hence, carotid intima‐media echogenicity appears to be involved in arterial wall remodeling, yet may mimic a different facet of this process than CIMT.
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Affiliation(s)
- Anouk L M Eikendal
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Karlijn A Groenewegen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sanne A E Peters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands The George Institute for Global Health, University of Oxford, United Kingdom
| | - Cuno S P M Uiterwaal
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Hester M den Ruijter
- Laboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
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36
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Aizawa K, Elyas S, Adingupu DD, Casanova F, Gooding KM, Shore AC, Strain WD, Gates PE. Echogenicity of the Common Carotid Artery Intima-Media Complex in Stroke. ULTRASOUND IN MEDICINE & BIOLOGY 2016; 42:1130-1137. [PMID: 26944528 DOI: 10.1016/j.ultrasmedbio.2016.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 12/18/2015] [Accepted: 01/12/2016] [Indexed: 06/05/2023]
Abstract
The grey-scale median of the common carotid artery intima-media complex (IM-GSM) characterizes arterial wall composition, and a low IM-GSM is associated with increased cardiovascular mortality in the elderly. We aimed to determine differences in the IM-GSM between a cohort with cerebrovascular disease and a healthy cohort. Eighty-two healthy individuals (control group: 63.2 ± 8.7 y) and 96 patients with either stroke or transient ischemic attacks (CRVD group: 68.6 ± 9.8 y) were studied. Common carotid artery intima-media thickness and IM-GSM obtained by ultrasound were analyzed using semi-automated edge-detection software. The IM-GSM was significantly lower in the CRVD group than in the control group (106 ± 24 vs. 124 ± 27 au, p < 0.001). The IM-GSM was similar for the infarct and non-infarct sides in CRVD. In the pooled cohort of all participants, the lower the quartile of IM-GSM, the greater were the carotid artery intima-media thickness and carotid artery remodeling. These results suggest the presence of an altered atherosclerotic phenotype in the intima-media complex of CRVD patients that can be detected by ultrasound.
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Affiliation(s)
- Kunihiko Aizawa
- Diabetes and Vascular Medicine Research Centre, University of Exeter Medical School, Exeter, UK; NIHR Exeter Clinical Research Facility, Exeter, UK.
| | - Salim Elyas
- Diabetes and Vascular Medicine Research Centre, University of Exeter Medical School, Exeter, UK; NIHR Exeter Clinical Research Facility, Exeter, UK; Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Damilola D Adingupu
- Diabetes and Vascular Medicine Research Centre, University of Exeter Medical School, Exeter, UK; NIHR Exeter Clinical Research Facility, Exeter, UK
| | - Francesco Casanova
- Diabetes and Vascular Medicine Research Centre, University of Exeter Medical School, Exeter, UK; NIHR Exeter Clinical Research Facility, Exeter, UK
| | - Kim M Gooding
- Diabetes and Vascular Medicine Research Centre, University of Exeter Medical School, Exeter, UK; NIHR Exeter Clinical Research Facility, Exeter, UK
| | - Angela C Shore
- Diabetes and Vascular Medicine Research Centre, University of Exeter Medical School, Exeter, UK; NIHR Exeter Clinical Research Facility, Exeter, UK
| | - W David Strain
- Diabetes and Vascular Medicine Research Centre, University of Exeter Medical School, Exeter, UK; NIHR Exeter Clinical Research Facility, Exeter, UK; Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Phillip E Gates
- Diabetes and Vascular Medicine Research Centre, University of Exeter Medical School, Exeter, UK; NIHR Exeter Clinical Research Facility, Exeter, UK
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37
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Li H, Zhang S, Ma R, Chen H, Xi S, Zhang J, Fang J. Ultrasound intima-media thickness measurement of the carotid artery using ant colony optimization combined with a curvelet-based orientation-selective filter. Med Phys 2016; 43:1795. [PMID: 27036577 DOI: 10.1118/1.4943567] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE Automatic measurement of the intima-media thickness (IMT) from ultrasound carotid images is an important task in clinical diagnosis. Many computer-based techniques for IMT measurement have been proposed to overcome the limits of manual segmentation. However, the robustness of the algorithms would be influenced by the inherent speckle noise of ultrasound image. This paper proposed a curvelet guided ant colony optimization (CGACO) strategy that could achieve satisfied accuracy for IMT measurement with improved robustness to noise. METHODS The curvelet-based orientation-selective (CBOS) filter was first introduced for speckle removal and edge enhancement. Different from conventional methods, CBOS filter processes the curvelet coefficients by orientations rather than by magnitude. Then, a specially designed two-leg ant colony optimization technique, combined with Otsu thresholding and Sobel edge detector, was proposed as a novel segmentation method to extract the media-adventitia (MA) and the lumen-intima (LI) boundaries. Finally, a coupled snake model was employed to further smooth the contours of MA and LI. RESULTS In addition to 224 carotid artery images acquired from 34 participants, simulated speckled images with nine levels of noise were also included in the database. The mean absolute distance errors of CGACO for LI interface tracings, MA interface tracings, and IMT measurements were 0.030 ± 0.027, 0.039 ± 0.036, and 0.041 ± 0.036 mm, respectively. Besides, CGACO had a correlation coefficient as high as 0.992 and a bias as low as -0.008. All these measures were comparable to or better than a previous technique and the manual segmentation. On the other hand, CGACO had the highest success rate of 98.7% in the segmentation of real data. It also maintained a much higher success rate in the segmentation of simulated images with different levels of speckle noise. CONCLUSIONS The proposed technique showed accurate IMT measurement results. Furthermore, benefiting from the CBOS filter, the robustness to noise of the algorithm was substantially improved. Therefore, CGACO could provide a reliable way to segment the carotid artery from ultrasound images and could be used in clinical practice of IMT measurement, particularly in early atherosclerotic stages.
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Affiliation(s)
- Hao Li
- Academy of Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China
| | - Shijie Zhang
- Academy of Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China
| | - Rui Ma
- VINNO Technology Co., Ltd., Suzhou 215123, China
| | - Huiren Chen
- VINNO Technology Co., Ltd., Suzhou 215123, China
| | - Shui Xi
- VINNO Technology Co., Ltd., Suzhou 215123, China
| | - Jue Zhang
- Academy of Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China and College of Engineering, Peking University, Beijing 100871, China
| | - Jing Fang
- Academy of Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China and College of Engineering, Peking University, Beijing 100871, China
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Automatic Lumen Detection on Longitudinal Ultrasound B-Mode Images of the Carotid Using Phase Symmetry. SENSORS 2016; 16:s16030350. [PMID: 27005631 PMCID: PMC4813925 DOI: 10.3390/s16030350] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 03/01/2016] [Accepted: 03/03/2016] [Indexed: 11/17/2022]
Abstract
This article describes a method that improves the performance of previous approaches for the automatic detection of the common carotid artery (CCA) lumen centerline on longitudinal B-mode ultrasound images. We propose to detect several lumen centerline candidates using local symmetry analysis based on local phase information of dark structures at an appropriate scale. These candidates are analyzed with selection mechanisms that use symmetry, contrast or intensity features in combination with position-based heuristics. Several experimental results are provided to evaluate the robustness and performance of the proposed method in comparison with previous approaches. These results lead to the conclusion that our proposal is robust to noise, lumen artifacts, contrast variations and that is able to deal with the presence of CCA-like structures, significantly improving the performance of our previous approach, from 87.5% ± 0.7% of correct detections to 98.3% ± 0.3% in a set of 200 images.
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39
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Xiao L, Li Q, Bai Y, Zhang L, Tang J. Automated Measurement Method of Common Carotid Artery Intima-Media Thickness in Ultrasound Image Based on Markov Random Field Models. J Med Biol Eng 2015. [DOI: 10.1007/s40846-015-0074-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ring M, Eriksson MJ, Jogestrand T, Caidahl K. Ultrasound measurements of carotid intima-media thickness by two semi-automated analysis systems. Clin Physiol Funct Imaging 2015; 36:389-95. [DOI: 10.1111/cpf.12241] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 01/27/2015] [Indexed: 11/29/2022]
Affiliation(s)
- M. Ring
- Department of Molecular Medicine and Surgery; Karolinska Institutet; Stockholm Sweden
| | - M. J. Eriksson
- Department of Molecular Medicine and Surgery; Karolinska Institutet; Stockholm Sweden
| | - T. Jogestrand
- Department of Laboratory Medicine; Karolinska Institutet; Stockholm Sweden
| | - K. Caidahl
- Department of Molecular Medicine and Surgery; Karolinska Institutet; Stockholm Sweden
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Menchón-Lara RM, Sancho-Gómez JL. Fully automatic segmentation of ultrasound common carotid artery images based on machine learning. Neurocomputing 2015. [DOI: 10.1016/j.neucom.2014.09.066] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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43
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Sandoo A, Kitas GD. A methodological approach to non-invasive assessments of vascular function and morphology. J Vis Exp 2015. [PMID: 25741637 PMCID: PMC4354622 DOI: 10.3791/52339] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The endothelium is the innermost lining of the vasculature and is involved in the maintenance of vascular homeostasis. Damage to the endothelium may predispose the vessel to atherosclerosis and increase the risk for cardiovascular disease. Assessments of peripheral endothelial function are good indicators of early abnormalities in the vascular wall and correlate well with assessments of coronary endothelial function. The present manuscript details the important methodological steps necessary for the assessment of microvascular endothelial function using laser Doppler imaging with iontophoresis, large vessel endothelial function using flow-mediated dilatation, and carotid atherosclerosis using carotid artery ultrasound. A discussion on the methodological considerations for each of the techniques is also presented, and recommendations are made for future research.
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Affiliation(s)
- Aamer Sandoo
- School of Sport, Health and Exercise Sciences, Bangor University; Department of Rheumatology, Dudley Group of Hospitals NHS Trust, Russells Hall Hospital;
| | - George D Kitas
- Department of Rheumatology, Dudley Group of Hospitals NHS Trust, Russells Hall Hospital; Arthritis Research UK Epidemiology Unit, University of Manchester
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Akkus Z, Carvalho DDB, van den Oord SCH, Schinkel AFL, Niessen WJ, de Jong N, van der Steen AFW, Klein S, Bosch JG. Fully automated carotid plaque segmentation in combined contrast-enhanced and B-mode ultrasound. ULTRASOUND IN MEDICINE & BIOLOGY 2015; 41:517-531. [PMID: 25542485 DOI: 10.1016/j.ultrasmedbio.2014.10.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 09/29/2014] [Accepted: 10/07/2014] [Indexed: 06/04/2023]
Abstract
Carotid plaque segmentation in B-mode ultrasound (BMUS) and contrast-enhanced ultrasound (CEUS) is crucial to the assessment of plaque morphology and composition, which are linked to plaque vulnerability. Segmentation in BMUS is challenging because of noise, artifacts and echo-lucent plaques. CEUS allows better delineation of the lumen but contains artifacts and lacks tissue information. We describe a method that exploits the combined information from simultaneously acquired BMUS and CEUS images. Our method consists of non-rigid motion estimation, vessel detection, lumen-intima segmentation and media-adventitia segmentation. The evaluation was performed in training (n = 20 carotids) and test (n = 28) data sets by comparison with manually obtained ground truth. The average root-mean-square errors in the training and test data sets were comparable for media-adventitia (411 ± 224 and 393 ± 239 μm) and for lumen-intima (362 ± 192 and 388 ± 200 μm), and were comparable to inter-observer variability. To the best of our knowledge, this is the first method to perform fully automatic carotid plaque segmentation using combined BMUS and CEUS.
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Affiliation(s)
- Zeynettin Akkus
- Department of Biomedical Engineering, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands
| | - Diego D B Carvalho
- Departments of Medical Informatics & Radiology, Biomedical Imaging Group Rotterdam, Erasmus MC, Rotterdam, The Netherlands
| | | | - Arend F L Schinkel
- Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands
| | - Wiro J Niessen
- Departments of Medical Informatics & Radiology, Biomedical Imaging Group Rotterdam, Erasmus MC, Rotterdam, The Netherlands; Imaging Physics, Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands
| | - Nico de Jong
- Department of Biomedical Engineering, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands; Imaging Physics, Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands
| | - Antonius F W van der Steen
- Department of Biomedical Engineering, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands; Imaging Physics, Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands
| | - Stefan Klein
- Departments of Medical Informatics & Radiology, Biomedical Imaging Group Rotterdam, Erasmus MC, Rotterdam, The Netherlands
| | - Johan G Bosch
- Department of Biomedical Engineering, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
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Bastida-Jumilla M, Menchón-Lara R, Morales-Sánchez J, Verdú-Monedero R, Larrey-Ruiz J, Sancho-Gómez J. Frequency-domain active contours solution to evaluate intima–media thickness of the common carotid artery. Biomed Signal Process Control 2015. [DOI: 10.1016/j.bspc.2014.08.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Simultaneous extraction of carotid artery intima-media interfaces in ultrasound images: assessment of wall thickness temporal variation during the cardiac cycle. Int J Comput Assist Radiol Surg 2014; 9:645-58. [PMID: 24122509 DOI: 10.1007/s11548-013-0945-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Accepted: 09/04/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The aim of this work is to present and evaluate a novel segmentation method for localizing the contours of the intima-media complex in the carotid artery wall through longitudinal ultrasound B-mode imaging. The method is used to investigate the association between atherosclerosis risk factors and the cyclic variation of the intima-media thickness during the heart beat. METHODS The framework introduced is based on two main features. The first is a simultaneous extraction of both the lumen-intima and the media-adventitia interfaces, using the combination of an original shape-adapted filter bank and a specific dynamic programming scheme. The second is an innovative spatial transformation that eases the extraction of skewed and curved contours, and exploits the result from the previous image as a priori information, when processing the current image. The intima-media thickness is automatically derived from the estimated contours for each time step during the cardiac cycle. Our method was evaluated in vivo on 57 healthy volunteers and 25 patients at high cardiovascular risk. Reference contours were generated for each subject by averaging the tracings performed by three experienced observers. RESULTS Segmentation errors were 29 ± 27 μm for the lumen-intima interface, 42 ± 38 μm for the media-adventitia interface, and 22 ± 16 μm for the intima-media thickness. This uncertainty was similar to inter- and intra-observer variability. Furthermore, the amplitude of the temporal variation in thickness of the intima-media layers during the cardiac cycle was significantly higher in at-risk patients compared to healthy volunteers (79 ± 36 vs. 64 ± 26 μm, p = 0.032). Conclusion: The method proposed may provide a relevant diagnostic aid for atherosclerosis screening in clinical studies.
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Lind L. Flow-mediated vasodilation over five years in the general elderly population and its relation to cardiovascular risk factors. Atherosclerosis 2014; 237:666-70. [PMID: 25463103 DOI: 10.1016/j.atherosclerosis.2014.10.092] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 10/20/2014] [Accepted: 10/20/2014] [Indexed: 01/12/2023]
Abstract
BACKGROUND Flow-mediated vasodilation (FMD) has previously been shown to be related to cardiovascular risk factors in cross-sectional studies. The present study aims to investigate how FMD changes over time, and determine whether this change is paralleled by changes in cardiovascular risk factors. METHODS Of the participants in the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study, 750 individuals had measurements made of FMD in the brachial artery both at the ages of 70 and 75 years. In addition, the change over the 5 years in carotid artery intima-media thickness (IMT) was monitored, as well as traditional cardiovascular risk factors. RESULTS While no significant change in FMD occurred during the 5-year period (+0.1%, p = 0.53), large changes could be seen at the individual level. The Framingham risk score (excluding the age-variable) increased during the follow-up period (+0.54, p < 0.001). This change was inversely related to the individual change in FMD (beta -0.15, 95% CI -0.29 to -0.0059, p = 0.041). Of the eight individual CV risk factors tested, the change in FMD was only related to the change in LDL-cholesterol (inversely, p = 0.0028). The change in FMD was not related to the change in IMT seen over the 5-year period (p = 0.41). CONCLUSION While no change was seen in the mean FMD over a five-year period in elderly subjects attending both examinations despite ageing and a change in several risk factors, the individual change was mainly related to the change in LDL-cholesterol, further emphasizing the important role of lipids to determine vasoreactivity.
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Affiliation(s)
- Lars Lind
- Department of Medical Sciences, Uppsala University, SE-751 85 Uppsala, Sweden.
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A review of ultrasound common carotid artery image and video segmentation techniques. Med Biol Eng Comput 2014; 52:1073-93. [PMID: 25284219 DOI: 10.1007/s11517-014-1203-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Accepted: 09/22/2014] [Indexed: 10/24/2022]
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Sifakis EG, Golemati S. Robust carotid artery recognition in longitudinal B-mode ultrasound images. IEEE TRANSACTIONS ON IMAGE PROCESSING : A PUBLICATION OF THE IEEE SIGNAL PROCESSING SOCIETY 2014; 23:3762-3772. [PMID: 24968172 DOI: 10.1109/tip.2014.2332761] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Automatic segmentation of the arterial lumen from ultrasound images is an important task in clinical diagnosis. Carotid artery recognition, the first task in lumen segmentation, should be performed in a fully automated, fast, and reliable way to further facilitate the low-level task of arterial delineation. In this paper, a user-independent, real-time algorithm is introduced for carotid artery localization in longitudinal B-mode ultrasound images. The proposed technique acts directly on the raw image, and exploits basic statistics along with anatomical knowledge. The method's evaluation and parameter value optimization were performed on a threefold cross validation basis. In addition, the introduced algorithm was systematically compared with another algorithm for common carotid artery recognition in B-mode scans, separately for multi-frame and single-frame data. The data sets used included 2,149 images from 100 subjects taken from three different institutions and covering a wide range of possible lumen and surrounding tissue representations. Using the optimized values, the carotid artery was recognized in all the processed images in both multi-frame and single-frame data. Thus, the introduced technique will further reinforce automatic segmentation in longitudinal B-mode ultrasound images.
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Abstract
Oxidative stress is linked to several human diseases, including nonalcoholic steatohepatitis (NASH). In this study, lymphocytes were used as a model to study this disease. These cells offer several advantages for cellular and molecular studies such as easy accessibility, and they are easily accessible and constitute a "time-persistent" system capable of reflecting the condition of the whole organism. Lymphocytes from patients with NASH display oxidative stress features. Among the possible causes for the overproduction of reactive oxygen species in NASH lymphocytes, there might be alterations of enzymatic pathways, auto-oxidation of glucose and mitochondrial superoxide production, which, in turn, would lead to protein oxidative damage. Increased oxidative stress in lymphocytes from patients with NASH may result in a pro-oxidative environment, which, in turn, could modify the pathway of the enzymatic activities. The data confirm that an imbalance between pro-oxidant and antioxidant defense mechanisms may be an important factor in NASH.
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