Three-Dimensional Ultrasound for Sensitive Assessment of the Effects of Nutritional Therapy on Carotid Atherosclerosis

Dietary supplements have a much smaller effect on atherosclerosis compared to powerful medical therapies such as high-dose statins. Therefore, sensitive and cost-effective biomarkers are required to evaluate the efficacy of such supplements. We present two methods for assessing the effect of nutritional therapy (pomegranate juice/tablets) using three-dimensional ultrasound imaging. The first is a plaque texture biomarker representing the changes of 376 plaque textural features. The second measures the weighted average vessel-wall-plus-plaque thickness (VWT), computed by taking an average of the VWT-Change distribution weighted by a map highlighting anatomic locations likely to exhibit plaque changes. The two biomarkers were able to detect the difference between the treatment and placebo groups in a clinical trial evaluating the effect of pomegranate. These biomarkers reduce the number of subjects required to establish significance in a 1-year study by more than one order of magnitude compared to total plaque volume. The reduction in the cost required to evaluate new treatments will shorten the period that effective treatments are withheld from patients.