Key result
Carotid plaque motion analysis on 2D ultrasound lacks robust and reproducible evaluation methods.
Why the study?
Whole plaque and intraplaque area motion has not been widely investigated in 2D B-mode longitudinal carotid ultrasound videos to identify high-risk plaques.
Systematic Review
Current methodologies for carotid plaque motion analysis in 2D B-mode ultrasound lack standardization, with significant gaps remaining in evaluating complex plaque motion for stroke risk prediction.
Answers are grounded in this paper and cite their sources.
Carotid plaque motion analysis remains exploratory; leaves open standardized validation before any clinical stroke risk use.
Carotid B-mode ultrasound (U/S) video analysis enables the detection of temporal changes in plaque features, which might help identify patients at increased risk of ischemic stroke. Despite existing evidence, whole plaque and intraplaque area motion has not been widely investigated in 2D B-mode longitudinal carotid U/S videos. Here, we collected, filtered and discussed previous studies proposing different methodologies for carotid plaque motion analysis in 2D B-mode U/S videos. Our main objective was to investigate whether robust and reproducible methods exist for plaque motion analysis in 2D B-mode longitudinal U/S videos, obtained in a clinical setting. Also, whether any of them has been considered to assist doctors in detecting high-risk plaques, based on the analysis of all intraplaque areas. We searched for eminent methodological gaps, possibly evoking the necessity for further analysis of the individual plaque components. We searched on PubMed, Scopus, and IEEE, from 2012 to 2024, considering studies that fulfilled the following criteria: a. inclusion of 2D B-mode longitudinal U/S image sequences or videos, b. inclusion of Asymptomatic (AS) and Symptomatic (SY) patients with carotid stenosis ≥ 50 %, and c. studies involving carotid plaques (not the intima-media thickness). We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR 2020) guidelines. Notably, unanswered questions still remain, such as how motion should be evaluated in cases with > 1 plaque area and how the (set of) specific intraplaque areas, whose discordant motion might be heavily involved in plaque rupture in AS or SY cases, could be identified.
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Liapi et al. (2026) conducted a systematic review in Carotid stenosis ≥ 50%. Plaque motion analysis in 2D B-mode longitudinal U/S videos was evaluated on Robust and reproducible methods for plaque motion analysis. Plaque motion analysis in 2D B-mode longitudinal carotid ultrasound videos lacks robust, reproducible methods, with unanswered questions on evaluating motion in cases with multiple plaque areas.
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