**5. Conclusions**

In this paper we have proposed a new method to segmen<sup>t</sup> the atheroma plaque based on strain measurements with low computational and time costs. This work is a theoretical framework and has been developed and tested with FE models with idealized and real IVUS geometries. The representation of the SGVs opens the possibility of segmenting the lipid core with different strain variables. This representation is used in the W-GVF segmentation to extract the tissues and measure the FCT and lipid area for the clinical diagnosis. We made an extensive study of the strain variables used for the W-GVF segmentation and selected only those who detect the lipid core and other tissues. The method had good results in all scenarios, showing an SI value higher than 94% (with noise). There are strain variables such as |*<sup>ε</sup>vMises*| in combination with |*<sup>ε</sup>r<sup>θ</sup>* | or *<sup>ε</sup>yy* + |*<sup>ε</sup>rr*| that achieved accurate results regardless of the geometry, morphological changes, or noise addition. Furthermore, single SGVs such as *dW* or |*<sup>ε</sup>min*| could provide the lipid segmentation. Although the methodology has to be tested with in vivo data, it has promising preliminary results.

**Author Contributions:** Conceptualization of the study: J.O. and E.P. Investigation and methodology: A.T.L. Supervision: M.A.M., M.C. and E.P. Writing: A.T.L. Review and editing: A.T.L., M.C., M.A.M., J.O. and E.P. Funding acquisition, M.A.M. and E.P. All authors have read and agreed to the published version of the manuscript.

**Funding:** This work was supported by the Spanish Ministry of Science and Technology through research project PID2019-107517RB-I00, the regional Government of Aragón support for the funding of the research project T24-20R, and gran<sup>t</sup> CUS/581/2020. CIBER Actions are financed by the Instituto de Salud Carlos III with assistance from the European Regional Development Fund. Jacques Ohayon was supported by the SIMR project (2019–2023) operated by the French National Research Agency.

**Data Availability Statement:** Not applicable.

**Acknowledgments:** We would like to thank Santiago Cruz (Department of Electronic Engineering and Communications of University of Zaragoza) for the helpful discussion on the segmentation procedure.

**Conflicts of Interest:** The authors declare no conflict of interest.
