ARFI variance of acceleration (VoA) for noninvasive characterization of human carotid plaques in vivo

Rather than degree of stenosis, assessing plaque structure and composition is relevant to discerning risk for plaque rupture with downstream ischemic event. The structure and composition of carotid plaque has been assessed noninvasively using Acoustic Radiation Force Impulse (ARFI) ultrasound imaging. In particular, ARFI-derived peak displacement (PD) estimations have been demonstrated for discriminating soft (lipid rich necrotic core (LRNC) or intraplaque hemorrhage (IPH)) from stiff (collagen (COL) or calcium (CAL)) plaque features; however, PD did not differentiate LRNC from IPH or COL from CAL. The purpose of this study is to evaluate a new ARFI-based measurement, the variance of acceleration (VoA), for differentiating among soft and stiff plaque components. Both PD and VoA results were obtained in vivo for a human carotid plaque acquired in a previous study and matched to a histological standard analyzed by a pathologist. With VoA, plaque feature contrast was increased by an average of 60% in comparison to PD.