ArticleThe international journal of cardiovascular imaging2023
Imaging modality-dependent carotid stenosis severity variations against intravascular ultrasound as a reference: Carotid Artery intravasculaR Ultrasound Study (CARUS).
Article in The international journal of cardiovascular imaging, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Carotid Plaque-RADS: Impact of its ancillary features on improving the detection of symptomatic plaques.European radiology · 2026Article
- Comment on "Laparoscopic and robotic extravascular stenting of the left renal vein for anterior nutcracker syndrome in a single-center series".Journal of vascular surgery. Venous and lymphatic disorders · 2026Article
- The Effect of Lesion Length on Doppler Velocities Used Routinely to Determine Carotid Stenosis Cross-Sectional Severity.Diagnostics (Basel, Switzerland) · 2025Article
- Carotid Stenosis and Stroke: Medicines, Stents, Surgery-"Wait-and-See" or Protect?Thrombosis and haemostasis · 2024Article
- Editor's choice to the October 2023 issue.The international journal of cardiovascular imaging · 2023Article
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Authors and funding
13 authors.
Funding
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Abstract
purposeDifferent non-invasive and invasive imaging modalities are used to determine carotid artery stenosis severity that remains a principal parameter in clinical decision-making. We compared stenosis degree obtained with different modalities against vascular imaging gold standard, intravascular ultrasound, IVUS.
methods300 consecutive patients (age 47-83 years, 192 men, 64% asymptomatic) with carotid artery stenosis of " ≥ 50%" referred for potential revascularization received as per study protocol (i) duplex ultrasound (DUS), (ii) computed tomography angiography (CTA), (iii) intraarterial quantitative angiography (iQA) and (iv) and (iv) IVUS. Correlation of measurements with IVUS (r), proportion of those concordant (within 10%) and proportion of under/overestimated were calculated along with recipient-operating-characteristics (ROC).
resultsFor IVUS area stenosis (AS) and IVUS minimal lumen area (MLA), there was only a moderate correlation with DUS velocities (peak-systolic, PSV; end-diastolic, EDV; r values of 0.42-0.51, p < 0.001 for all). CTA systematically underestimated both reference area and MLA (80.4% and 92.3% cases) but CTA error was lesser for AS (proportion concordant-57.4%; CTA under/overestimation-12.5%/30.1%). iQA diameter stenosis (DS) was found concordant with IVUS in 41.1% measurements (iQA under/overestimation 7.9%/51.0%). By univariate model, PSV (ROC area-under-the-curve, AUC, 0.77, cutoff 2.6 m/s), EDV (AUC 0.72, cutoff 0.71 m/s) and CTA-DS (AUC 0.83, cutoff 59.6%) were predictors of ≥ 50% DS by IVUS (p < 0.001 for all). Best predictor, however, of ≥ 50% DS by IVUS was stenosis severity evaluation by automated contrast column density measurement on iQA (AUC 0.87, cutoff 68%, p < 0.001). Regarding non-invasive techniques, CTA was the only independent diagnostic modality against IVUS on multivariate model (p = 0.008).
conclusionIVUS validation shows significant imaging modality-dependent variations in carotid stenosis severity determination.
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