Aaron Fenster PhD, FCCPM
Director and Scientist, Imaging Research Laboratories, Robars Research Institute
Canada Research Chair in Biomedical Engineering (Tier 1)
Director, Graduate Program in Biomedical Engineering
Professor, Diagnostic Radiology and Nuclear Medicine, Medical Biophysics, Biomedical Engineering, Western University
Ultrasound-guided breast biopsy
Ultrasound-guided and robotically-aided prostate brachytherapy
Ultrasound vascular imaging
Carotid ultrasound is a valuable tool for measuring and tracking carotid plaque area over time. Dr. Spence outlines how 3D ultrasound methods are used to calculate plaque area, which is an important predictor of stroke, myocardial infarction and death, and to follow plaque progression or regression, which are critical treatment targets. Using this novel approach, Dr. Spence et al. have found that a change in therapeutic strategies, targeting the arteries and not LDL levels, has led to less disease progression in their test population despite a rise in mean patient age.
Using specialized equipment and advanced software, Dr. Fenster et al. have extended 2 dimensional ultrasound images to 3 dimensional acquisition. Through further software development, it has been possible for his team to reconstruct and measure existing carotid plaque in real time, allowing for accurate mapping of plaque regression or progression over time. Looking forward, Dr. Fenster describes current programs attempting to semi-automate plaque tracing on images.
Working within the goal of CAIN2, Dr. Spence outlines the importance and methods towards outlining atherosclerosis patients would would benefit from intervention. It has been determined that those with microemboli and with greater than 3 ulcers benefit and that characteristics of individual plaque predicts outcome. CAIN2 strives to validate imaging methods for detection of vulnerable plaque.
While imaging is recognized as a useful tool to characterize atherosclerosis and its complications, there is a critical need to undertake large population studies to truly understand the natural history of the disease as well as the links between imaging biomarkers and patient outcomes. This presentation outlines the objectives of CAIN3, which are to compare the extent of atherosclerosis, and rate of atherosclerosis progression in different vascular beds and to determine the correlation between imaging biomarkers and cardiovascular outcomes.
Dr. Jean-Claude Tardif, leader of the CAIN and MITNEC imaging networks, sets the stage with an overview of each network and how they are related. The networks, while varied in focus, strive to overcome key challenges of medical imaging research, learning to harness potential developments to improve clinical practice. As a good primer, this presentation is recommended to all ImagingKT members.