Reproducibility in Echotracking Assessment of Local Carotid Stiffness, Diameter and Thickness in a Population-based Study (The STANISLAS Cohort Study)

Background Carotid Intima Media Thickness (IMT) and stiffness are associated with cardiovascular events. The study aims were to perform a head-to-head comparison of the Wall Track System (WTS) and ART.LAB for carotid IMT, distension and diameter echotracking measurements as well as inter- and intra-observer reproducibility. Methods Echotracking measurements were performed with WTS and ART.LAB in 188 participants from the STANISLAS Cohort (mean age 47 ± 14 years). Inter-observer reproducibility analysis was performed in 60 patients consecutively included among the STANISLAS Cohort and two other ongoing cohorts, in whom measurements were successively performed by three operators. Results The relative differences between WTS and ART.LAB in artery diameter measurements were minimal (mean difference -1.8%) while the differences in IMT and distension measurements were 6.1% and 4.3%, respectively. The Bland and Altman plots for diameter, distension and intima media thickness showed no measurement bias between ART.LAB and WTS. The internal reproducibility for carotid diameter was good with the two devices (≈2% SD). The ART.LAB performed ≈2-fold better than WTS for IMT internal reproducibility (5% vs. 12.5%, p < 0.0001) and distension internal reproducibility (6.3% vs. 12.4%, p < 0.0001). The inter- and intra-observer reproducibility for carotid diameter and IMT was good for both devices. Complete results were obtained in 1:50 min in ART.LAB and 11:13 min with WTS. Conclusion ART.LAB and WTS show good agreement, with good inter- and intra-observer reproducibility with the two devices. Nevertheless, internal reproducibility of ART.LAB is better and measurements are easier to perform, favouring this device for carotid intima media thickness and stiffness measurements.