Accurate quantification of atherosclerotic plaque volume by 3D vascular ultrasound using the volumetric linear array method

Beatriz López-Melgar, Leticia Fernández-Friera, Javier Sánchez-González, Jean Paul Vilchez, Alberto Cecconi, Jesús Mateo, José L. Peñalvo, Belén Oliva, Jose M. García-Ruiz, Steve Kauffman, Luis Jesús Jiménez-Borreguero, Jesús Ruiz-Cabello, Antonio Fernández-Ortiz, Borja Ibáñez, Valentín Fuster

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Introduction: Direct quantification of atherosclerotic plaque volume by three-dimensional vascular ultrasound (3DVUS) is more reproducible than 2DUS-based three-dimensional (2D/3D) techniques that generate pseudo-3D volumes from summed 2D plaque areas; however, its accuracy has not been reported. We aimed to determine 3DVUS accuracy for plaque volume measurement with special emphasis on small plaques (a hallmark of early atherosclerosis). Methods: The in vitro study consisted of nine phantoms of different volumes (small and medium-large) embedded at variable distances from the surface (superficial vs. >5 cm-depth) and comparison of 3DVUS data generated using a novel volumetric-linear array method with the real phantom volumes. The in vivo study was undertaken in a rabbit model of atherosclerosis in which 3DVUS and 2D/3D volume measurements were correlated against gold-standard histological measurements. Results: In the in vitro setting, there was a strong correlation between 3DVUS measures and real phantom volume both for small (3.0-64.5 mm3 size) and medium-large (91.1-965.5 mm3 size) phantoms embedded superficially, with intraclass correlation coefficients (ICC) of 0.99 and 0.98, respectively; conversely, when phantoms were placed at >5 cm, the correlation was only moderate (ICC = 0.67). In the in vivo setting there was strong correlation between 3DVUS-measured plaque volumes and the histological gold-standard (ICC = 0.99 [4.02-92.5 mm3 size]). Conversely, the correlation between 2D/3D values and the histological gold standard (sum of plaque areas) was weaker (ICC = 0.87 [49-520 mm2 size]), with large dispersion of the differences between measurements in Bland-Altman plots (mean error, 79.2 mm2). Conclusions: 3DVUS using the volumetric-linear array method accurately measures plaque volumes, including those of small plaques. Measurements are more accurate for superficial arterial territories than for deep territories.

Original languageEnglish
Pages (from-to)230-237
Number of pages8
StatePublished - 1 May 2016


  • Accuracy
  • Atherosclerotic plaque
  • Gold-standard
  • Plaque volume
  • Three-dimensional
  • Vascular ultrasound


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