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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

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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 \(29 \pm 27\,\upmu \hbox {m}\) for the lumen-intima interface, \(42 \pm 38\,\upmu \hbox {m}\) for the media-adventitia interface, and \(22 \pm 16\,\upmu \hbox {m}\) 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 \((79 \pm 36\) vs. \(64 \pm 26\,\upmu \hbox {m},\, p=0.032)\).

Conclusion

   The method proposed may provide a relevant diagnostic aid for atherosclerosis screening in clinical studies.

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Notes

  1. We drop \(n\) to simplify the notations, when it is not confusing, since all the subsequent steps detailed in this section are performed on the same time-point \(n\).

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Acknowledgments

This work was done within the French ANR Labex PRIMES and CeLyA. The authors would like to thank Dr. ir. Theo van Walsum, Dr. ir. Stefan Klein, and Dr. Aad van der Lugt for their valuable suggestions when proofreading the manuscript.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. CREATIS, CNRS UMR 5220, INSERM U1044, INSA-Lyon, Université Lyon 1, Université de Lyon, Lyon, France

    Guillaume Zahnd, Maciej Orkisz & Didier Vray

  2. Biomedical Imaging Group Rotterdam, Departments of Radiology and Medical Informatics, Erasmus MC, P.O. Box 2040, 3000 CA , Rotterdam, The Netherlands

    Guillaume Zahnd

  3. Department of Radiology, Louis Pradel Hospital, Lyon, France

    André Sérusclat

  4. Department of Endocrinology, Louis Pradel Hospital, Hospices Civils de Lyon, Université Lyon, Lyon, France

    Philippe Moulin

  5. INSERM UMR 1060, Lyon, France

    Philippe Moulin

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  1. Guillaume Zahnd
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Correspondence to Guillaume Zahnd.

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Zahnd, G., Orkisz, M., Sérusclat, A. et al. Simultaneous extraction of carotid artery intima-media interfaces in ultrasound images: assessment of wall thickness temporal variation during the cardiac cycle. Int J CARS 9, 645–658 (2014). https://doi.org/10.1007/s11548-013-0945-0

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