The accuracy of arteriography and ultrasound imaging for atherosclerosis measurement. A review.

We reviewed the accuracy of contrast arteriography and ultrasound imaging procedures compared with autopsy findings. We propose that measurement of change in atherosclerotic lesions may substitute for mortality and morbidity of ischemic heart disease in clinical trials. Requirements of accuracy and precision for this application are more demanding than current clinical needs and are set by expected change rates of atherosclerotic lesions. Twelve studies that compared selective coronary arteriography with autopsy showed that arteriography generally underestimated the severity of atherosclerosis. Ultrasound B-mode, Doppler, and duplex images were compared with angiography in 21 studies, but have not been adequately calibrated at autopsy. We recommend that additional calibration of both imaging procedures against autopsy results be performed and be keyed to projected clinical applications.