New carotid imaging technique offers speedy, noninvasive CVD risk assessment

A new, noninvasive technique for imaging the carotid artery can offer insight into plaque characteristics in real time, leading one researcher to suggest the modality could become as popular as ultrasound.

That researcher, Daniel Razansky, PhD, and co-authors published their early experience with volumetric multi-spectral optoacoustic tomography (vMSOT) on Feb. 12 in Radiology. The new technique involves holding a handheld device to a patient’s neck as spectroscopy provides images up to 30 mm deep, which is enough to visualize the carotid bifurcation area in most patients, Razansky and co-authors wrote. Many ischemic strokes are related to carotid artery disease originating from that area.

"Unlike most other clinical imaging modalities mainly looking at late-stage anatomical manifestations of diseases, vMSOT is capable of sensing specific molecules in tissues without administration of contrast agents," Razansky, director of the Functional and Molecular Imaging Lab at the University of Zurich, said in a press release. "In the case of carotid artery disease, assessment of the entire bifurcation area in real time and in 3-D is only possible with vMSOT."

The authors performed both vMSOT and conventional ultrasound in 16 healthy volunteers and compared the results, which showed the vMSOT approach was “less prone than ultrasound to motion-related, image-blurring artifacts,” according to the release.

Given these results, Razansky et al. believe the new modality holds promise for the early detection of image-based biomarkers of cardiovascular disease, which can aid in diagnosis and treatment decisions.

“Of potentially greater significance is the possibility that the spectroscopic imaging might distinguish the vulnerable from the stable plaque,” Reuben S. Mezrich, MD, wrote in a related editorial. “This would have the potential to change medical management of the patient with a carotid artery lesion. It could also serve as a research tool, enabling studies of the effects of different therapies on the constituents of a plaque in vivo.”

Razansky et al. noted ultrasound may provide more detailed anatomic information in some cross-sectional views due to the differing levels of contrast delivered, but they said vMSOT could eventually be used alongside ultrasound for more complete carotid imaging.

"Given its fast imaging performance, excellent molecular contrast, portability and affordability, I truly believe that vMSOT will soon be routinely used in the clinic," Razansky said. "One day, it may even become as popular as ultrasound."