ESCAPE Stroke: first results

Introduction: “ESCAPE Stroke” (Enhancement, Seg-mentation and Characterization of Atheroma PlaquE for Stroke Prevention) is a multidisciplinary project that aims to develop a new software tool to obtain maximum information about carotid atherosclerosis, through the (semi)automatic analysis of the morpholo-gical characteristics of the carotid plaque.

Objective: We present the first results for evaluating this software. For the morphological analysis of the characteristics of the atheroma plaques, a database of 117 carotid ultrasound images was used. The extracted morphological features refer to the degree of echoge-nicity, texture and the surface of the atheroma plaque.

Methods: Regarding to echogenicity of the atheroma plaques, the implemented software algorithm divides the plaques into four classes as follows: • Anechogenic A type, the echogenic areas representing less than 25% of the plaque. The 117 plaques subjected to compute-rized analysis were classified as: 54 Type E plaques, 57 Type E / 2 plaques, 6 Type A / 2 plaques and no Type A plaques • A / 2 type: predominantly anechogenic, ane-chogenic areas accounting for more than 50% of the plaque but less than 75%; • Type E / 2: predominantly echogenic, echogenic areas accounting for more than 50% of the plaque but less than 75%; • Type E: echoge-nic, an-echogenic areas representing less than 25% of the plaque;

Results: On the subject of texture of atheroma plaques, the implemented software algorithm studies the homo-geneity. In order to quantify the degree of homogeneity of the atheroma plaques, a number of functions have been calculated that have become the homogeneity-classification parameters. The 117 plaques were divi-ded into three different classes as follows: • 28 plaques type 1, with uniform consistency regardless of their echogenicity; • 51 plaques type 2, with an average non-uniform consistency, the distribution of gray levels in the atheroma plaque varies but does not go throu-gh the entire interval from hypo-echogenic zones to hyper-echogenic zones; • 38 plaques type 3, with high non-uniform consistency, with hypo-echogenic and hyper-echogenic zones. With regard to the surface of the atheroma plaques, it is defined as smooth and regu-lar, slightly irregular or ulcerated. Using different con-tour parameters, the 117 atheroma plaques subjected to computerized analysis were classified as follows: • 48 plaques with smooth and regular surface; • 55 plaques with slightly irregular surface; • 14 plaques with ulce-rative surface;

Conclusions: Our automated / semi-automated me-thod for characterizing the atheromatogram may add important information in assessing atherosclerotic lesi-ons, but additional research is needed to assess clinical relevance, correlations with cardiovascular risk, and to confirm its reproducibility, accuracy and value in cur-rent practice.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)