Image: 3D model of a femoral artery obtained by real 3D imaging (Photo courtesy of CNIC)
The burden, or quantity, of atherosclerosis in the carotid and femoral arteries is a well-established marker of cardiovascular risk and is highlighted as a key parameter in international clinical practice guidelines and expert consensus documents. There is a recognized need for better and easy-to-use methods for measuring plaque burden that can be used as population screening tools. A new imaging technique for real 3D vascular ultrasound could become a key tool in strategies aimed at preventing cardiovascular disease in apparently healthy persons, complementing traditional risk parameters such as cholesterol and high blood pressure.
The new imaging method was first validated and implemented in a study of almost 200 healthy participants with an intermediate cardiovascular risk by researchers at CNIC (Madrid, Spain) who partnered with Royal Philips (Amsterdam, the Netherlands) to develop a new probe and software for real 3D ultrasound in order to facilitate exploration of the carotid and femoral arteries and speed up quantification of atherosclerotic plaque volume. The newly validated 3D vascular probe incorporates 3D matrix technology, which underpins the most advanced 3D ultrasound techniques.
The new technology allows simultaneous analysis by 2D and 3D ultrasound, includes all functionalities (color Doppler, power-Doppler, and contrast ultrasound), and is easily incorporated into daily clinical practice by technical and medical teams already experienced in ultrasound. The method has now been incorporated into the PESA-CNIC-SANTANDER study where it is being used to assess more than 4000 healthy individuals over a nine-year follow-up. The PESA-CNIC-SANTANDER study, which started in 2010 and was recently extended until 2030, is one of the most important cardiovascular prevention studies in the world.
In addition to demonstrating the accuracy of 3D matrix ultrasound, the study demonstrates that the new technique takes just half the time needed by previous methods to obtain all the information required for the definition of carotid and femoral plaque burden, essential information for correct patient management. For patients, the outstanding feature of the new method is that the software generates a virtual 3D image of their own arteries, allowing them to see the accumulated damage.
“We now have a tool that can be used on-the-fly in an initial consultation, speeding up decision making - an important consideration in cardiovascular prevention, where time is of the essence,” said first author Dr. Beatriz López Melgar, a cardiologist at Hospital Universitario La Princesa and head of the 3D Cardioprevention Program at Hospital HM Montepríncipe. “We believe that the development of ultrasound methods will contribute to the expansion of personalized medicine and the use of diagnostic imaging techniques, and will also help to ensure that improvements in patient care produce benefits for a larger sector of the population.”