Web-based accurate measurements of carotid lumen diameter and stenosis severity: An ultrasound-based clinical tool for stroke risk assessment during multicenter clinical trials
This pilot study presents a completely automated, novel, smart, cloud-based, point-of-care system for (a) carotid lumen diameter (LD); (b) stenosis severity index (SSI) and (c) total lumen area (TLA) measurement using B-mode ultrasound. The proposed system was (i) validated against manual reading ta...
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| Veröffentlicht in: | Computers in biology and medicine 2017-12, Vol.91, p.306-317 |
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| creator | Saba, Luca Banchhor, Sumit K. Londhe, Narendra D. Araki, Tadashi Laird, John R. Gupta, Ajay Nicolaides, Andrew Suri, Jasjit S. |
| description | This pilot study presents a completely automated, novel, smart, cloud-based, point-of-care system for (a) carotid lumen diameter (LD); (b) stenosis severity index (SSI) and (c) total lumen area (TLA) measurement using B-mode ultrasound. The proposed system was (i) validated against manual reading taken by the Neurologist and (ii) benchmarked against the commercially available system.
One hundred patients (73 M/27 F, mean age: 68 ± 11 years), institutional review board approved, written informed consent, consisted of left/right common carotid artery (200 ultrasound scans) were acquired using a 7.5-MHz linear transducer.
The measured mean LD for left and right carotids were (in mm): (i) for proposed system (6.49 ± 1.77, 6.66 ± 1.70); and (ii) for manual (6.29 ± 1.79, 6.45 ± 1.63), respectively and coefficient of correlation between cloud-based automated against manual were 0.98 (P |
| doi_str_mv | 10.1016/j.compbiomed.2017.10.022 |
| format | Article |
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One hundred patients (73 M/27 F, mean age: 68 ± 11 years), institutional review board approved, written informed consent, consisted of left/right common carotid artery (200 ultrasound scans) were acquired using a 7.5-MHz linear transducer.
The measured mean LD for left and right carotids were (in mm): (i) for proposed system (6.49 ± 1.77, 6.66 ± 1.70); and (ii) for manual (6.29 ± 1.79, 6.45 ± 1.63), respectively and coefficient of correlation between cloud-based automated against manual were 0.98 (P < 0.0001) and 0.99 (P < 0.0001), respectively. The corresponding TLA error, Precision-of-Merit, and Figure-of-Merit when measured against the manual were: 4.56 ± 3.54%, 96.18 ± 3.21%, and 96.85%, respectively.
The AUC for the receiving operating characteristics for the cloud-based system was: 1.0. Four statistical tests such as: Two-tailed z-test, Mann-Whitney test, Kolmogorov-Smirnov (KS) and one-way ANOVA were performed to demonstrate consistency and reliability.
The proposed system is reliable, accurate, fast, completely automated, anytime-anywhere solution for multi-center clinical trials and routine vascular screening.
•A novel web-based vascular ultrasound system for stroke risk assessment.•Statistical tests demonstrate consistency, reliability, and accuracy of the system.•The proposed system was validated against the manual tracings by a Neuroradiologist.•The system is adaptable for vascular screening and multi-center clinical trials.•The system is currently being used in teleradiology mode in several countries.</description><identifier>ISSN: 0010-4825</identifier><identifier>EISSN: 1879-0534</identifier><identifier>DOI: 10.1016/j.compbiomed.2017.10.022</identifier><identifier>PMID: 29107894</identifier><language>eng</language><publisher>United States: Elsevier Ltd</publisher><subject>Aged ; Atherosclerosis ; Automation ; Cardiovascular disease ; Carotid arteries ; Carotid Arteries - diagnostic imaging ; Carotid artery ; Carotid Intima-Media Thickness ; Carotid Stenosis - diagnostic imaging ; Carotid Stenosis - epidemiology ; Clinical trials ; Cloud-based ; Coronary vessels ; Error analysis ; Female ; Flow velocity ; Health risks ; Humans ; Informed consent ; Internet ; Language ; Lumen diameter ; Male ; Medical research ; Middle Aged ; Performance evaluation ; Preventive medicine ; Risk Assessment ; Software ; Statistical analysis ; Statistical tests ; Stenosis ; Stroke ; Stroke - diagnostic imaging ; Stroke - epidemiology ; Telemedicine ; Total lumen area ; Ultrasonic imaging ; Ultrasonography - methods ; Ultrasound ; Variance analysis</subject><ispartof>Computers in biology and medicine, 2017-12, Vol.91, p.306-317</ispartof><rights>2017 Elsevier Ltd</rights><rights>Copyright © 2017 Elsevier Ltd. All rights reserved.</rights><rights>Copyright Elsevier Limited Dec 1, 2017</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c402t-c62e8fcc20cfaf7af40bc607e0f2581b0908bc2c59438b3833e145b0a477bbf83</citedby><cites>FETCH-LOGICAL-c402t-c62e8fcc20cfaf7af40bc607e0f2581b0908bc2c59438b3833e145b0a477bbf83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0010482517303487$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29107894$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Saba, Luca</creatorcontrib><creatorcontrib>Banchhor, Sumit K.</creatorcontrib><creatorcontrib>Londhe, Narendra D.</creatorcontrib><creatorcontrib>Araki, Tadashi</creatorcontrib><creatorcontrib>Laird, John R.</creatorcontrib><creatorcontrib>Gupta, Ajay</creatorcontrib><creatorcontrib>Nicolaides, Andrew</creatorcontrib><creatorcontrib>Suri, Jasjit S.</creatorcontrib><title>Web-based accurate measurements of carotid lumen diameter and stenosis severity: An ultrasound-based clinical tool for stroke risk assessment during multicenter clinical trials</title><title>Computers in biology and medicine</title><addtitle>Comput Biol Med</addtitle><description>This pilot study presents a completely automated, novel, smart, cloud-based, point-of-care system for (a) carotid lumen diameter (LD); (b) stenosis severity index (SSI) and (c) total lumen area (TLA) measurement using B-mode ultrasound. The proposed system was (i) validated against manual reading taken by the Neurologist and (ii) benchmarked against the commercially available system.
One hundred patients (73 M/27 F, mean age: 68 ± 11 years), institutional review board approved, written informed consent, consisted of left/right common carotid artery (200 ultrasound scans) were acquired using a 7.5-MHz linear transducer.
The measured mean LD for left and right carotids were (in mm): (i) for proposed system (6.49 ± 1.77, 6.66 ± 1.70); and (ii) for manual (6.29 ± 1.79, 6.45 ± 1.63), respectively and coefficient of correlation between cloud-based automated against manual were 0.98 (P < 0.0001) and 0.99 (P < 0.0001), respectively. The corresponding TLA error, Precision-of-Merit, and Figure-of-Merit when measured against the manual were: 4.56 ± 3.54%, 96.18 ± 3.21%, and 96.85%, respectively.
The AUC for the receiving operating characteristics for the cloud-based system was: 1.0. Four statistical tests such as: Two-tailed z-test, Mann-Whitney test, Kolmogorov-Smirnov (KS) and one-way ANOVA were performed to demonstrate consistency and reliability.
The proposed system is reliable, accurate, fast, completely automated, anytime-anywhere solution for multi-center clinical trials and routine vascular screening.
•A novel web-based vascular ultrasound system for stroke risk assessment.•Statistical tests demonstrate consistency, reliability, and accuracy of the system.•The proposed system was validated against the manual tracings by a Neuroradiologist.•The system is adaptable for vascular screening and multi-center clinical trials.•The system is currently being used in teleradiology mode in several countries.</description><subject>Aged</subject><subject>Atherosclerosis</subject><subject>Automation</subject><subject>Cardiovascular disease</subject><subject>Carotid arteries</subject><subject>Carotid Arteries - diagnostic imaging</subject><subject>Carotid artery</subject><subject>Carotid Intima-Media Thickness</subject><subject>Carotid Stenosis - diagnostic imaging</subject><subject>Carotid Stenosis - epidemiology</subject><subject>Clinical trials</subject><subject>Cloud-based</subject><subject>Coronary vessels</subject><subject>Error analysis</subject><subject>Female</subject><subject>Flow velocity</subject><subject>Health risks</subject><subject>Humans</subject><subject>Informed consent</subject><subject>Internet</subject><subject>Language</subject><subject>Lumen diameter</subject><subject>Male</subject><subject>Medical research</subject><subject>Middle Aged</subject><subject>Performance evaluation</subject><subject>Preventive medicine</subject><subject>Risk Assessment</subject><subject>Software</subject><subject>Statistical analysis</subject><subject>Statistical tests</subject><subject>Stenosis</subject><subject>Stroke</subject><subject>Stroke - diagnostic imaging</subject><subject>Stroke - epidemiology</subject><subject>Telemedicine</subject><subject>Total lumen area</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography - methods</subject><subject>Ultrasound</subject><subject>Variance analysis</subject><issn>0010-4825</issn><issn>1879-0534</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkc2KFTEQhYMoznX0FSTgxk1fK_3f7sbBPxhwo7hskuqK5E53ck2lB-atfETT3DsMuHFVcOo7dUKOEFLBXoFq3x32GJajcWGhaV-C6rK8h7J8Inaq74YCmqp-KnYACoq6L5sL8YL5AAA1VPBcXJSDgq4f6p3485NMYTTTJDXiGnUiuZDmNdJCPrEMVqKOIblJzmuW5OT0Qomi1H6SnMgHdiyZ7ii6dP9eXnm5zilqDqufzqdxdt6hnmUKYZY2xGyM4ZZkdHwrNTMxb3FyWqPzv-SSLzjMQo559EanZ34pntk86NV5Xoofnz5-v_5S3Hz7_PX66qbAGspUYFtSbxFLQKttp20NBlvoCGzZ9MrAAL3BEpuhrnpT9VVFqm4M6LrrjLF9dSnenu4eY_i9EqdxcYw0z9pTWHlUQ6vaqlGDyuibf9BDWKPPr9uoJgfkIjLVnyiMgTmSHY_RLTrejwrGrdXxMD62Om6tbpvcara-PgesZts9GB9qzMCHE0D5R-4cxZHRkUeaXCRM4xTc_1P-ApwIvUY</recordid><startdate>20171201</startdate><enddate>20171201</enddate><creator>Saba, Luca</creator><creator>Banchhor, Sumit K.</creator><creator>Londhe, Narendra D.</creator><creator>Araki, Tadashi</creator><creator>Laird, John R.</creator><creator>Gupta, Ajay</creator><creator>Nicolaides, Andrew</creator><creator>Suri, Jasjit S.</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AL</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>JQ2</scope><scope>K7-</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0N</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7P</scope><scope>M7Z</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20171201</creationdate><title>Web-based accurate measurements of carotid lumen diameter and stenosis severity: An ultrasound-based clinical tool for stroke risk assessment during multicenter clinical trials</title><author>Saba, Luca ; Banchhor, Sumit K. ; Londhe, Narendra D. ; Araki, Tadashi ; Laird, John R. ; Gupta, Ajay ; Nicolaides, Andrew ; Suri, Jasjit S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c402t-c62e8fcc20cfaf7af40bc607e0f2581b0908bc2c59438b3833e145b0a477bbf83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Atherosclerosis</topic><topic>Automation</topic><topic>Cardiovascular disease</topic><topic>Carotid arteries</topic><topic>Carotid Arteries - diagnostic imaging</topic><topic>Carotid artery</topic><topic>Carotid Intima-Media Thickness</topic><topic>Carotid Stenosis - diagnostic imaging</topic><topic>Carotid Stenosis - epidemiology</topic><topic>Clinical trials</topic><topic>Cloud-based</topic><topic>Coronary vessels</topic><topic>Error analysis</topic><topic>Female</topic><topic>Flow velocity</topic><topic>Health risks</topic><topic>Humans</topic><topic>Informed consent</topic><topic>Internet</topic><topic>Language</topic><topic>Lumen diameter</topic><topic>Male</topic><topic>Medical research</topic><topic>Middle Aged</topic><topic>Performance evaluation</topic><topic>Preventive medicine</topic><topic>Risk Assessment</topic><topic>Software</topic><topic>Statistical analysis</topic><topic>Statistical tests</topic><topic>Stenosis</topic><topic>Stroke</topic><topic>Stroke - diagnostic imaging</topic><topic>Stroke - epidemiology</topic><topic>Telemedicine</topic><topic>Total lumen area</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography - methods</topic><topic>Ultrasound</topic><topic>Variance analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Saba, Luca</creatorcontrib><creatorcontrib>Banchhor, Sumit K.</creatorcontrib><creatorcontrib>Londhe, Narendra D.</creatorcontrib><creatorcontrib>Araki, Tadashi</creatorcontrib><creatorcontrib>Laird, John R.</creatorcontrib><creatorcontrib>Gupta, Ajay</creatorcontrib><creatorcontrib>Nicolaides, Andrew</creatorcontrib><creatorcontrib>Suri, Jasjit S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Computing Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Computer Science Collection</collection><collection>Computer Science Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Computing Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Biological Science Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Computers in biology and medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Saba, Luca</au><au>Banchhor, Sumit K.</au><au>Londhe, Narendra D.</au><au>Araki, Tadashi</au><au>Laird, John R.</au><au>Gupta, Ajay</au><au>Nicolaides, Andrew</au><au>Suri, Jasjit S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Web-based accurate measurements of carotid lumen diameter and stenosis severity: An ultrasound-based clinical tool for stroke risk assessment during multicenter clinical trials</atitle><jtitle>Computers in biology and medicine</jtitle><addtitle>Comput Biol Med</addtitle><date>2017-12-01</date><risdate>2017</risdate><volume>91</volume><spage>306</spage><epage>317</epage><pages>306-317</pages><issn>0010-4825</issn><eissn>1879-0534</eissn><abstract>This pilot study presents a completely automated, novel, smart, cloud-based, point-of-care system for (a) carotid lumen diameter (LD); (b) stenosis severity index (SSI) and (c) total lumen area (TLA) measurement using B-mode ultrasound. The proposed system was (i) validated against manual reading taken by the Neurologist and (ii) benchmarked against the commercially available system.
One hundred patients (73 M/27 F, mean age: 68 ± 11 years), institutional review board approved, written informed consent, consisted of left/right common carotid artery (200 ultrasound scans) were acquired using a 7.5-MHz linear transducer.
The measured mean LD for left and right carotids were (in mm): (i) for proposed system (6.49 ± 1.77, 6.66 ± 1.70); and (ii) for manual (6.29 ± 1.79, 6.45 ± 1.63), respectively and coefficient of correlation between cloud-based automated against manual were 0.98 (P < 0.0001) and 0.99 (P < 0.0001), respectively. The corresponding TLA error, Precision-of-Merit, and Figure-of-Merit when measured against the manual were: 4.56 ± 3.54%, 96.18 ± 3.21%, and 96.85%, respectively.
The AUC for the receiving operating characteristics for the cloud-based system was: 1.0. Four statistical tests such as: Two-tailed z-test, Mann-Whitney test, Kolmogorov-Smirnov (KS) and one-way ANOVA were performed to demonstrate consistency and reliability.
The proposed system is reliable, accurate, fast, completely automated, anytime-anywhere solution for multi-center clinical trials and routine vascular screening.
•A novel web-based vascular ultrasound system for stroke risk assessment.•Statistical tests demonstrate consistency, reliability, and accuracy of the system.•The proposed system was validated against the manual tracings by a Neuroradiologist.•The system is adaptable for vascular screening and multi-center clinical trials.•The system is currently being used in teleradiology mode in several countries.</abstract><cop>United States</cop><pub>Elsevier Ltd</pub><pmid>29107894</pmid><doi>10.1016/j.compbiomed.2017.10.022</doi><tpages>12</tpages></addata></record> |
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| ispartof | Computers in biology and medicine, 2017-12, Vol.91, p.306-317 |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Aged Atherosclerosis Automation Cardiovascular disease Carotid arteries Carotid Arteries - diagnostic imaging Carotid artery Carotid Intima-Media Thickness Carotid Stenosis - diagnostic imaging Carotid Stenosis - epidemiology Clinical trials Cloud-based Coronary vessels Error analysis Female Flow velocity Health risks Humans Informed consent Internet Language Lumen diameter Male Medical research Middle Aged Performance evaluation Preventive medicine Risk Assessment Software Statistical analysis Statistical tests Stenosis Stroke Stroke - diagnostic imaging Stroke - epidemiology Telemedicine Total lumen area Ultrasonic imaging Ultrasonography - methods Ultrasound Variance analysis |
| title | Web-based accurate measurements of carotid lumen diameter and stenosis severity: An ultrasound-based clinical tool for stroke risk assessment during multicenter clinical trials |
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