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BioMed Research International
Volume 2014 (2014), Article ID 531389, 4 pages
Research Article

Comparison of Semi-Automated and Manual Measurements of Carotid Intima-Media Thickening

Department of Cardiology, Tallaght Hospital, Dublin 24, Ireland

Received 24 April 2013; Accepted 28 October 2013; Published 21 January 2014

Academic Editor: Ali AbuRahma

Copyright © 2014 Oscar Mac Ananey et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Carotid intima-media thickening (CIMT) is a marker of both arteriosclerotic and atherosclerotic risks. Technological advances have semiautomated CIMT image acquisition and quantification. Studies comparing manual and automated methods have yielded conflicting results possibly due to plaque inclusion in measurements. Low atherosclerotic risk subjects were recruited to minimise the effect of focal atherosclerotic lesions on CIMT variability. CIMT was assessed by high-resolution B-mode ultrasound (Philips HDX7E, Phillips, UK) images of the common carotid artery using both manual and semiautomated methods (QLAB, Phillips, UK). Intraclass correlation coefficient (ICC) and the mean differences of paired measurements (Bland-Altman method) were used to compare both methodologies. The ICC of manual (  mm) and automated (0.524 ± 0.068 mm) methods was and an absolute mean bias ± SD of  mm was observed. Interobserver and intraobserver ICC were greater for automated ( and 0.99) compared to manual ( and 0.88) methods. Although not considered to be clinically significant, manual measurements yielded higher values compared to automated measurements. Automated measurements were more reproducible and showed lower interobserver variation compared to manual measurements. These results offer important considerations for large epidemiological studies.