Carotid Ultrasound Boundary Study (CUBS): An Open Multicenter Analysis of Computerized Intima–Media Thickness Measurement Systems and Their Clinical Impact

Abstract

Common carotid intimaÀmedia thickness (CIMT) is a commonly used marker for atherosclerosis and is often computed in carotid ultrasound images. An analysis of different computerized techniques for CIMT measurement and their clinical impacts on the same patient data set is lacking. Here we compared and assessed five computerized CIMT algorithms against three expert analysts' manual measurements on a data set of 1088 patients from two centers. Inter-and intra-observer variability was assessed, and the computerized CIMT values were compared with those manually obtained. The CIMT measurements were used to assess the correlation with clinical parameters, cardiovascular event prediction through a generalized linear model and the KaplanÀMeier hazard ratio. CIMT measurements obtained with a skilled analyst's segmentation and the computerized segmentation were comparable in statistical analyses, suggesting they can be used interchangeably for CIMT quantification and clinical outcome investigation. To facilitate future studies, the entire data set used is made publicly

Segmenting the carotid-artery wall in ultrasound image sequences with a dual-resolution U-net

“…These errors were compared with the inter-and intra-observer variabilities, A2 vs. A1 and A1' vs. A1, respectively. Table I summarizes the segmentation errors separately calculated for images from the CUBS 1 and CUBS 2 databases, which allows a comparison with other methods evaluated on these databases in previous studies [5], [6]. Thus, the previous benchmark on the CUBS 1 database was a MAD value on IMT equal to 114 ± 117 µm, while on the CUBS 2 database the best conventional method achieved 139 ± 119 µm and another Unet-based method obtained 178 ± 120 µm.…”

“…The latter achieved errors smaller than the interobserver variability, both in terms of estimated thickness and contour location. Compared to the methods already evaluated on the same data [5], [6], caroSegDeep established a new benchmark. As the proposed method is based on supervised learning, it has the potential to increase its performance by using larger and more diverse data for training.…”

Variability of Common Carotid Intima-media Thickness Measured using B-mode and M-mode Ultrasound Imaging

“…Manual measurement of cIMT could be the source of variability between the two imaging modes and the use of an automated computerized analysis reduces the variability in measuring cIMT and is a preferable method for cIMT assessment [3,14]. However, it is worth mentioning that in clinical practice a manual measurement of cIMT is usually performed for being faster and more feasible in practice and might be available in centers due to lack of funding.…”

“…Atherosclerotic plaques in arteries are a major cause of cardiovascular diseases [2]. The thickness of the intima-media in the common carotid artery (cIMT), the measurement from the boundary of the lumen-intima to the media-adventitia interface, is a well-described surrogate marker for subclinical atherosclerosis [3]. Increased thickness of cIMT has been associated with cardiovascular diseases [4].…”

Generation of realistic simulated B-mode image texture with a GAN

“…We used a subset (n = 769) of in vivo images from the CUBS 1 [10] and CUBS 2 [9] databases. As the images also contain text and other graphical inlays, we clipped them out and cropped each sample down to only a region of interest (ROI).…”