Assessment of microvascular flow in human atherosclerotic carotid plaques using ultrasound localization microscopyResearch in context
Summary: Background: Neovascularisation of carotid plaques contributes to their vulnerability. Current imaging methods such as contrast-enhanced ultrasound (CEUS) usually lack the required spatial resolution and quantification capability for precise neovessels identification. We aimed at quantifyin...
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Elsevier
2025-01-01
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| author | Henri Leroy Louise Z. Wang Anatole Jimenez Nassim Mohamedi Clément Papadacci Pierre Julia Salma El Batti Jean-Marc Alsac Jonas Sitruk Armelle Arnoux Patrick Bruneval Emmanuel Messas Tristan Mirault Guillaume Goudot Mathieu Pernot |
| author_facet | Henri Leroy Louise Z. Wang Anatole Jimenez Nassim Mohamedi Clément Papadacci Pierre Julia Salma El Batti Jean-Marc Alsac Jonas Sitruk Armelle Arnoux Patrick Bruneval Emmanuel Messas Tristan Mirault Guillaume Goudot Mathieu Pernot |
| author_sort | Henri Leroy |
| collection | DOAJ |
| description | Summary: Background: Neovascularisation of carotid plaques contributes to their vulnerability. Current imaging methods such as contrast-enhanced ultrasound (CEUS) usually lack the required spatial resolution and quantification capability for precise neovessels identification. We aimed at quantifying plaque vascularisation with ultrasound localization microscopy (ULM) and compared the results to histological analysis. Methods: We conducted a prospective, monocentric, study involving patients who were undergoing carotid endarterectomy (CEA) for carotid artery stenosis. The day before CEA ultrasound examination coupled with the injection of microbubbles (MB) as a contrast agent (CEUS) to image the MB circulating within and around the carotid plaque was performed. CEUS images analysis classified patients into 2 groups: absence of neovascularisation (group A) or presence of neovascularisation (group B). ULM was performed by localising and tracking individual MB centres to reconstruct the neovessels structure with a resolution of around 60 μm. Plaques were manually segmented on the images to quantify the number of neovessels and various haemodynamic metrics inside the plaques. Histological analysis of the excised carotid plaque specimens classified patients into 2 groups: absence of neovascularisation (group I) or presence of neovascularisation (group II). Findings: Among the 26 patients included, classification was as follows: group I: n = 8 and group II: n = 18, 18 patients had analysable CEUS images and were classified as follows: group A: n = 10, group B: n = 8. The median (Q1-Q3) number of MB tracked per second inside the plaque was 0.03 (0–0.37) for patients in group I and 0.51 (0–3) for patients in group A versus (vs.) 3.55 (1.26–17.68) for patients in group II and 9.69 (5.83–34.68) for patients in group B (p = 0.00049; p = 0.010 respectively). The length of the MB tracks was 0.02 mm (0–0.16) in group I vs. 0.29 mm (0.22–0.45) in group II (p = 0.0069). The study also showed that flow in the neovessels was greater during systole than during diastole period: 9.38 (1.67–19.17) MB tracked per second vs. 1.35 (0.28–6.56) (p = 0.021). Interpretation: ULM allows the detection of neovessels within the carotid atherosclerotic plaque. Thus, ULM provides a precise picture of plaque neovascularisation in patients and could be used as a non-invasive imaging technique to assess carotid plaque vulnerability. Funding: The study was sponsored and funded by Assistance Publique–Hôpitaux de Paris (CRC 1806 APHP INNOVATION 2018). Co-funding by ART (Technological Research Accelerator) biomedical ultrasound program of INSERM, France. |
| format | Article |
| id | doaj-art-c693a3a0d86a47b0a6c4cac4c7685603 |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-c693a3a0d86a47b0a6c4cac4c76856032024-12-28T05:22:21ZengElsevierEBioMedicine2352-39642025-01-01111105528Assessment of microvascular flow in human atherosclerotic carotid plaques using ultrasound localization microscopyResearch in contextHenri Leroy0Louise Z. Wang1Anatole Jimenez2Nassim Mohamedi3Clément Papadacci4Pierre Julia5Salma El Batti6Jean-Marc Alsac7Jonas Sitruk8Armelle Arnoux9Patrick Bruneval10Emmanuel Messas11Tristan Mirault12Guillaume Goudot13Mathieu Pernot14Physics for Medicine Paris, INSERM U1273, ESPCI Paris, CNRS UMR 8063, PSL Research University, Paris, France; Corresponding author.Université Paris Cité, INSERM U970, Vascular Medicine Department, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP), F-75006, Paris, FrancePhysics for Medicine Paris, INSERM U1273, ESPCI Paris, CNRS UMR 8063, PSL Research University, Paris, FranceUniversité Paris Cité, INSERM U970, Vascular Medicine Department, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP), F-75006, Paris, FrancePhysics for Medicine Paris, INSERM U1273, ESPCI Paris, CNRS UMR 8063, PSL Research University, Paris, FranceUniversité Paris Cité, INSERM U970, Vascular Surgery Department, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP), F-75006, Paris, FranceUniversité Paris Cité, INSERM U970, Vascular Surgery Department, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP), F-75006, Paris, FranceUniversité Paris Cité, INSERM U970, Vascular Surgery Department, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP), F-75006, Paris, FranceUniversité Paris Cité, INSERM U970, Vascular Medicine Department, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP), F-75006, Paris, FranceUniversité Paris Cité, AP-HP, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP), Clinical Research Unit, Clinical Investigation Centre 1418 Clinical Epidemiology, INSERM, INRIA, HeKA, Paris, FranceUniversité Paris Cité, INSERM U970, Cardiology Department, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP), F-75006, Paris, FranceUniversité Paris Cité, INSERM U970, Vascular Medicine Department, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP), F-75006, Paris, FranceUniversité Paris Cité, INSERM U970, Vascular Medicine Department, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP), F-75006, Paris, FranceUniversité Paris Cité, INSERM U970, Vascular Medicine Department, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP), F-75006, Paris, FrancePhysics for Medicine Paris, INSERM U1273, ESPCI Paris, CNRS UMR 8063, PSL Research University, Paris, FranceSummary: Background: Neovascularisation of carotid plaques contributes to their vulnerability. Current imaging methods such as contrast-enhanced ultrasound (CEUS) usually lack the required spatial resolution and quantification capability for precise neovessels identification. We aimed at quantifying plaque vascularisation with ultrasound localization microscopy (ULM) and compared the results to histological analysis. Methods: We conducted a prospective, monocentric, study involving patients who were undergoing carotid endarterectomy (CEA) for carotid artery stenosis. The day before CEA ultrasound examination coupled with the injection of microbubbles (MB) as a contrast agent (CEUS) to image the MB circulating within and around the carotid plaque was performed. CEUS images analysis classified patients into 2 groups: absence of neovascularisation (group A) or presence of neovascularisation (group B). ULM was performed by localising and tracking individual MB centres to reconstruct the neovessels structure with a resolution of around 60 μm. Plaques were manually segmented on the images to quantify the number of neovessels and various haemodynamic metrics inside the plaques. Histological analysis of the excised carotid plaque specimens classified patients into 2 groups: absence of neovascularisation (group I) or presence of neovascularisation (group II). Findings: Among the 26 patients included, classification was as follows: group I: n = 8 and group II: n = 18, 18 patients had analysable CEUS images and were classified as follows: group A: n = 10, group B: n = 8. The median (Q1-Q3) number of MB tracked per second inside the plaque was 0.03 (0–0.37) for patients in group I and 0.51 (0–3) for patients in group A versus (vs.) 3.55 (1.26–17.68) for patients in group II and 9.69 (5.83–34.68) for patients in group B (p = 0.00049; p = 0.010 respectively). The length of the MB tracks was 0.02 mm (0–0.16) in group I vs. 0.29 mm (0.22–0.45) in group II (p = 0.0069). The study also showed that flow in the neovessels was greater during systole than during diastole period: 9.38 (1.67–19.17) MB tracked per second vs. 1.35 (0.28–6.56) (p = 0.021). Interpretation: ULM allows the detection of neovessels within the carotid atherosclerotic plaque. Thus, ULM provides a precise picture of plaque neovascularisation in patients and could be used as a non-invasive imaging technique to assess carotid plaque vulnerability. Funding: The study was sponsored and funded by Assistance Publique–Hôpitaux de Paris (CRC 1806 APHP INNOVATION 2018). Co-funding by ART (Technological Research Accelerator) biomedical ultrasound program of INSERM, France.http://www.sciencedirect.com/science/article/pii/S2352396424005644AtherosclerosisUltrasound imagingCarotid plaqueNeovascularisationSuper-resolution imagingContrast-enhanced ultrasound |
| spellingShingle | Henri Leroy Louise Z. Wang Anatole Jimenez Nassim Mohamedi Clément Papadacci Pierre Julia Salma El Batti Jean-Marc Alsac Jonas Sitruk Armelle Arnoux Patrick Bruneval Emmanuel Messas Tristan Mirault Guillaume Goudot Mathieu Pernot Assessment of microvascular flow in human atherosclerotic carotid plaques using ultrasound localization microscopyResearch in context EBioMedicine Atherosclerosis Ultrasound imaging Carotid plaque Neovascularisation Super-resolution imaging Contrast-enhanced ultrasound |
| title | Assessment of microvascular flow in human atherosclerotic carotid plaques using ultrasound localization microscopyResearch in context |
| title_full | Assessment of microvascular flow in human atherosclerotic carotid plaques using ultrasound localization microscopyResearch in context |
| title_fullStr | Assessment of microvascular flow in human atherosclerotic carotid plaques using ultrasound localization microscopyResearch in context |
| title_full_unstemmed | Assessment of microvascular flow in human atherosclerotic carotid plaques using ultrasound localization microscopyResearch in context |
| title_short | Assessment of microvascular flow in human atherosclerotic carotid plaques using ultrasound localization microscopyResearch in context |
| title_sort | assessment of microvascular flow in human atherosclerotic carotid plaques using ultrasound localization microscopyresearch in context |
| topic | Atherosclerosis Ultrasound imaging Carotid plaque Neovascularisation Super-resolution imaging Contrast-enhanced ultrasound |
| url | http://www.sciencedirect.com/science/article/pii/S2352396424005644 |
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