Published Online
on March 11, 2004

A more recent version of this article appeared on April 1, 2004

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Submitted on October 23, 2003
Revised on December 22, 2003
Accepted on December 24, 2003

Measurement of Carotid Plaque Volume by 3-Dimensional Ultrasound

Anthony Landry BSc; J. David Spence MD; and Aaron Fenster PhD^*

From the Imaging Research Laboratories, Robarts Research Institute, London, Ontario, Canada.

^* To whom correspondence should be addressed. E-mail: afenster{at}imaging.robarts.ca.

Background and Purpose--Measurement of carotid plaque volume and its progression are important tools for research and patient management. In this study, we investigate the observer variability in the measurement of plaque volume as determined by 3-dimensional (3D) ultrasound (US). We also investigate the effect of interslice distances (ISD) and repeated 3D US scans on measurement variability.

Materials and Methods--Forty 3D US patient images of plaques (range, 37.43 to 604.1 mm³) were measured by manual planimetry. We applied ANOVA to determine plaque volume measurement variability and reliability. Plaque volumes were measured with 9 ISDs to determine the effect of ISD on measurement variability. Additional plaque volumes were also measured from multiple 3D US scans to investigate repeated scan acquisition variability.

Results--Intraobserver and interobserver measurement reliabilities were 94% and 93.2%, respectively. Plaque volume measurement variability decreased with increasing plaque volume (range, 27.1% to 2.2%). Measurement precision was constant for ISDs between 1.0 and 3.0 mm, whereas plaque volume measurement variability increased with ISD. Repeated 3D US scan measurements were not different from single-scan measurements (P=0.867).

Conclusions--The coefficient of variation in the measurement of plaque volume decreased with plaque size. The volumetric change that must be observed to establish with 95% confidence that a plaque has undergone change is 20% to 35% for plaques <100 mm³ and 10% to 20% for plaques >100 mm³. Measurement precision was unchanged for ISDs <3.0 mm, whereas measurement variability increased with ISD. Repeated 3D US scans did not affect plaque volume measurement variability.

Key words: ultrasonography • carotid arteries • carotid artery diseases • carotid artery plaque • carotid stenosis

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