Improved Correlation between Carotid and Coronary Atherosclerosis SYNTAX Score Using Automated Ultrasound Carotid Bulb Plaque IMT Measurement

Nobutaka Ikeda, Ajay Gupta, Nilanjan Dey, Soumyo Bose, Shoaib Shafique, Tadashi Arak, Elisa Cuadrado Godia, Luca Saba, John R. Laird, Andrew Nicolaides, Jasjit S. Suri

Research output: Contribution to journalArticle

43 Scopus citations

Abstract

Described here is a detailed novel pilot study on whether the SYNTAX (Synergy between percutaneous coronary intervention with TAXUS and cardiac surgery) score, a measure of coronary artery disease complexity, could be better predicted with carotid intima-media thickness (cIMT) measures using automated IMT all along the common carotid and bulb plaque compared with manual IMT determined by sonographers. Three hundred seventy consecutive patients who underwent carotid ultrasound and coronary angiography were analyzed. SYNTAX score was determined from coronary angiograms by two experienced interventional cardiologists. Unlike most methods of cIMT measurement commonly used by sonographers, our method involves a computerized automated cIMT measurement all along the carotid artery that includes the bulb region and the region proximal to the bulb (under the class of AtheroEdge systems from AtheroPoint, Roseville, CA, USA). In this study, the correlation between automated cIMT that includes bulb plaque and SYNTAX score was found to be 0.467 (p<0.0001), compared with 0.391 (p<0.0001) for the correlation between the sonographer's IMT reading and SYNTAX score. The correlation between the automated cIMT and the sonographer's IMT was 0.882. When compared against the radiologist's manual tracings, automated cIMT system performance had a lumen-intima error of 0.007818 ± 0.0071mm, media-adventitia error of 0.0179 ± 0.0125mm and automated cIMT error of 0.0099 ± 0.00988mm. The precision of automated cIMT against the manual radiologist's reading was 98.86%. This current automated algorithm revealed a significantly stronger correlation between cIMT and coronary SYNTAX score as compared with the sonographer's cIMT measurements with multiple cardiovascular risk factors. We benchmarked our correlation between the automated cIMT that includes bulb plaque and SYNTAX score against a previously published (Ikeda etal. 2013) AtheroEdgeLink (AtheroPoint) correlation between the automated cIMT that does not include bulb plaque and SYNTAX score and had an improvement of 44.58%. By sampling cIMT in the bulb region, the automated cIMT technique improves the degree of correlation between coronary artery disease lesion complexity and carotid atherosclerosis characteristics.

Original languageEnglish (US)
Pages (from-to)1247-1262
Number of pages16
JournalUltrasound in Medicine and Biology
Volume41
Issue number5
DOIs
StatePublished - May 1 2015

Keywords

  • Angiogram
  • Automated carotid intima-media thickness
  • B-mode
  • Bulb plaque
  • Carotid artery
  • Coronary artery disease
  • Correlation
  • SYNTAX score
  • Ultrasound

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology
  • Biophysics

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    Ikeda, N., Gupta, A., Dey, N., Bose, S., Shafique, S., Arak, T., Godia, E. C., Saba, L., Laird, J. R., Nicolaides, A., & Suri, J. S. (2015). Improved Correlation between Carotid and Coronary Atherosclerosis SYNTAX Score Using Automated Ultrasound Carotid Bulb Plaque IMT Measurement. Ultrasound in Medicine and Biology, 41(5), 1247-1262. https://doi.org/10.1016/j.ultrasmedbio.2014.12.024