Automated ultrasound edge-tracking software comparable to established semi-automated reference software for carotid intima-media thickness analysis
Many commercial ultrasound systems are now including automated analysis packages for the determination of carotid intima-media thickness (cIMT); however, details regarding their algorithms and methodology are not published. Few studies have compared their accuracy and reliability with previously established automated software, and those that have were in asymptomatic adults. Therefore, this study compared cIMT measures from a fully automated ultrasound edge-tracking software (EchoPAC PC, Version 110.0.2; GE Medical Systems, Horten, Norway) to an established semi-automated reference software (Artery Measurement System (AMS) II, Version 1.141; Gothenburg, Sweden) in 30 healthy preschool children (ages 3–5 years) and 27 adults with coronary artery disease (CAD; ages 48–81 years). For both groups, Bland–Altman plots revealed good agreement with a negligible mean cIMT difference of −0·03 mm. Software differences were statistically, but not clinically, significant for preschool images (P = 0·001) and were not significant for CAD images (P = 0·09). Intra- and interoperator repeatability was high and comparable between software for preschool images (ICC, 0·90–0·96; CV, 1·3–2·5%), but slightly higher with the automated ultrasound than the semi-automated reference software for CAD images (ICC, 0·98–0·99; CV, 1·4–2·0% versus ICC, 0·84–0·89; CV, 5·6–6·8%). These findings suggest that the automated ultrasound software produces valid cIMT values in healthy preschool children and adults with CAD. Automated ultrasound software may be useful for ensuring consistency among multisite research initiatives or large cohort studies involving repeated cIMT measures, particularly in adults with documented CAD.