Three-dimensional ultrasound assessment of effects of therapies on carotid atherosclerosis using vessel wall thickness maps.

Abstract We present a new method for assessing the effects of therapies on atherosclerosis, by measuring the weighted average of carotid vessel-wall-plus-plaque thickness change ( Δ V W T ¯ W e i g h t e d ) in 120 patients randomized to pomegranate juice/extract versus placebo. Three-dimensional ultrasound images were acquired at baseline and one year after. Three-dimensional VWT maps were reconstructed and then projected onto a carotid template to obtain two-dimensional VWT maps. Anatomic correspondence on the two-dimensional VWT maps was optimized to reduce misalignment for the same subject and across subjects. A weight was computed at each point on the two-dimensional VWT map to highlight anatomic locations likely to exhibit plaque progression/regression, resulting in Δ V W T ¯ W e i g h t e d for each subject. The weighted average of VWT-Change measured from the two-dimensional VWT maps with correspondence alignment ( Δ V W T ¯ W e i g h t e d , M D L ) detected a significant difference between the pomegranate and placebo groups (P = 0.008). This method improves the cost-effectiveness of proof-of-concept studies involving new therapies for atherosclerosis.