title: Computerized analysing system using the active contour in ultrasound measurement of carotid artery intima-media thickness.
abstract: OBJECTIVE
  B-mode measurement of the carotid intima-media (IM) thickness (T) based on manual tracing (MT) procedures are dependent on the subjectivity of the reader and the existing automatic tracing procedures often fail to detect the IM boundaries accurately. The purpose of this study was to compare the tracing results of the IM boundaries of the carotid wall with a new automatic identification (AI) procedure, based on an active contour model, and computer-assisted manual tracing (MT).
  
  
  METHODS
  The detection of the IM boundaries was performed with both procedures in 126 ultrasound images [63 each of the common carotid artery (CCA) and carotid bulb] along the far wall of the distal CCA and the carotid bulb. Intra- and inter-reader variability for mean and maximum IMT with AI and MT and accuracy of identification of both IM boundaries were evaluated.
  
  
  RESULTS
  Using MT the intra- and inter-reader variability amounted to 0.01-0.03 and 0.03-0.07 mm, respectively. The variability was slightly higher in the carotid bulb than in the CCA. Using AI the variability was almost eliminated. Mean and maximum IMT were measured systematically lower by AI compared with MT in all regions by 0.01 mm. The accuracy of identification was similar for both IM boundaries, but lower in the carotid bulb region than in the CCA.
  
  
  CONCLUSIONS
  The new AI procedure identifies both IM boundaries in the region of the far wall of the CCA and carotid bulb with high precision, and eliminates most of the intra- and inter-reader variability of the IMT measurement using MT.
authors.affiliation: Centre for Internal Medicine, Department of Prevention, Rehabilitation and Sports Medicine, Freiburg University Hospital, Hugstetter strasse 55, 79106 Freiburg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Schmidt-Trucksäss
authors.forename: D C
authors.initials: DC
authors.lastname: Cheng
authors.forename: M
authors.initials: M
authors.lastname: Sandrock
authors.forename: J
authors.initials: J
authors.lastname: Schulte-Mönting
authors.forename: R
authors.initials: R
authors.lastname: Rauramaa
authors.forename: M
authors.initials: M
authors.lastname: Huonker
authors.forename: H
authors.initials: H
authors.lastname: Burkhardt
mesh_terms: D000328:Adult; D000368:Aged; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging*; D002346:Carotid Sinus / Q000000981:diagnostic imaging*; D003936:Diagnosis, Computer-Assisted / Q000592:standards*; D006801:Humans; D008875:Middle Aged; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D017540:Tunica Media / Q000000981:diagnostic imaging*; D014463:Ultrasonography