#1

As the subject…

Who has or is using CIMT imaging?

On a regular basis?

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#2

For those who do not know.

A basic search using an AI based search engine

CIMT Imaging Applications

CIMT (Carotid Intima-Media Thickness) imaging is a widely accepted and non-invasive technique used to assess the thickness of the intima and media layers of the carotid artery wall. This measurement provides valuable information about the presence and progression of atherosclerosis, a condition characterized by the buildup of plaque in the arteries.

How CIMT Imaging Works

CIMT imaging typically employs ultrasound technology to measure the thickness of the carotid artery wall. The test is usually performed on the neck, where the carotid arteries are easily accessible. The ultrasound probe sends high-frequency sound waves through the skin and into the artery, and the echoes are used to create detailed images of the artery wall.

Clinical Applications

CIMT imaging has several clinical applications:

Risk Assessment: CIMT measurements can help identify individuals at high risk for cardiovascular disease, including heart attack and stroke.

Monitoring Disease Progression: CIMT imaging can track changes in artery thickness over time, allowing healthcare providers to monitor the effectiveness of treatments and make adjustments as needed.

Early Detection: CIMT testing can detect subtle changes in artery thickness, even before symptoms of atherosclerosis appear.

Interpretation of Results

CIMT measurements are usually categorized into four classes, with higher values indicating greater plaque buildup and increased cardiovascular risk. Healthcare providers use these results, along with other risk factors, to develop personalized treatment plans aimed at reducing the risk of cardiovascular events.

In Summary

CIMT imaging is a non-invasive, widely accepted technique for assessing atherosclerosis and cardiovascular risk. By measuring carotid artery wall thickness, healthcare providers can identify high-risk individuals, monitor disease progression, and detect early signs of atherosclerosis, ultimately guiding treatment decisions and improving patient outcomes.

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#3

I got my first CIMT ultrasound for $275 (self pay price) earlier this year and my intima media thickness came back as 0.779mm (left Carotid) and 0.726 mm (right Carotid) which was interpreted as “no detectable plaque”.

The exact cutoff is somewhat arbitrary since the normal level of intima media thickness (without plaque) can vary from person to person between 0.6 mm to 0.8 mm and generally plaque is considered confirmed if the CIMT value exceeds 0.9 mm. Ideally you take a measurement repeatedly over the years, in which case any increase is likely to indicate plaque formation.

The Carotid artery is quite large with the internal diameter around 8 mm, so to get 50% occlusion (the earliest level at which blood flow is obstructed) would require the CIMT to increase by 2.0 mm (on both sides) or by 4.0 mm (on one side).

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#4

I think it might also be technician dependent- so ideally do it with the same technician each time also?

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#5

I have had 4 scans to track plaque thickness in my cartoid artery over last 3 years. Also can tell soft from hard. Very useful, but you really need a skilled ultrasound tech to get best images. I just got a CT angiogram with contrast which is the gold standard. Will do every 5 yrs.

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#6

I’m increasingly sold on the whole body MRI with MRA neck and head. The amount of valuable information out of that, on vascular system is substantial. Having clean carotids, vertebrals (can’t look at that on US and can only view the external carotids, not the segments up higher) and also looks at branches of your cerebral arteries for disease (including aneurysm), an furthermore lets you know if you have some small vessel disease - which is a little different, albeit related to forming plaques.
I’m more and more trying to get my patients over 50 to get the $1250 product SimonOne has as I think it is the best deal and also looks and tracks hippocampal sized which is predictive of neurocognitive decline.
That’s not to mention all the rest of the body gets done.
So yes a CIMT is a good screening paired with a CT Cardiac Calcium and is more cost effective - but the level of information and certainty is less with that strategy.

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#7

I’m glad to hear this. It’s especially valuable to have as a ‘baseline’ so you can compare changes over time. Honestly… it gave me far more valuable information than any blood test I’ve taken. I also continue to take the GRAIL liquid biopsy every year.

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#8

I’m not sure what I’d do with a positive result on Grail and a negative MRI. If your T cells are doing their job, and it is so tiny can’t see on a 3T MRI …

On my reading, I think TruDiagnostic’s EPISEEK is looking better than Grail? EPISEEK

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#9

I’ll try out EPISEEK next time. It looks $200 cheaper. I honestly don’t know how to properly compare the two services, or if there have been any legitimate studies between the two.

3 year ago, Grail said they could catch 20% of stage I, 45% of stage II, 81% of stage III. Again, I’m just taking their word here.

#10

EPISEEK seems to have almost 2x the FP rate of Grail : So you get slightly higher sensitivity but instead of PPV= 0.43 (57% FP rate) with Grail you are likely to have a 75% FP rate with EPISEEK.

If you get a positive result with Grail (or EPISEEK) you will at least need an $600 MRI to confirm it and if the MRI is negative you will need to decide if you want to pay for a more sensitive $1500 PET scan to be sure you have ruled out cancer, none of which will be covered by insurance (in USA). Alternately you could just repeat the $600 MRI after 6 or 12 months to see if the cancer has grown large enough for the MRI to detect.

Instead of the $600 MRI followup (after 6 or 12 months), you could also get the $650 SimonOne that just excludes the MRA neck and head and high sensitivity Prostate/Ovary cancer scan.

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#11

This illustrates why not just skip episeek / GRAIL and just do a yearly MRI?. If cost is an issue, do the $650 body one and every 2-3 years get the MRA neck and head and neuroquant.

There are a significant amount of cancers that regress either spontaneously or with a good immune system …. I’d be more interested when we can see it than a having a test result I don’t know what to do with?

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