Three-dimensional Ultrasound Imaging of Carotid Atherosclerosis

Three-dimensional ultrasound (3DUS) imaging measurements of carotid atherosclerosis are increasingly being investigated for monitoring the progression and regression of plaque burden in longitudinal studies. In this paper, we review the recent advancements of 3DUS imaging in terms of novel carotid atherosclerosis measurements, image processing techniques, and clinical trials. Lumen stenos is is the current imaging clinical standard for monitoring atherosclerosis. In addition, during the last two decades intima-media thickness is also used as a surrogate measurement of carotid atherosclerosis to assess disease severity in clinical trials. However, 3DUS measurements such as total plaque volume, vessel wall volume, and vessel wall thickness maps may be more sensitive metrics of the disease as they reflect the volumetric changes of the lesion along the length of the artery. Recently, numerous semi-automated techniques have been developed to segment the lumen and outer wall boundaries and plaque. There are also attempts to compute plaque composition from 3DUS images. Finally, we will review the clinical trials that involve 3DUS imaging.