{'fraction_non_alphanumeric': 0.04435483870967742, 'fraction_numerical': 0.029737903225806453, 'mean_word_length': 5.4869281045751634, 'pattern_counts': {'":': 0, '<': 2, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Fully Automated Dual‐Snake Formulation for Carotid Intima‐Media Thickness Measurement

Automated computer‐aided detection systems for measurement of the carotid intima‐media thickness (IMT) are becoming popular. These systems yield lumen‐intima (LI) and media‐adventitia (MA) borders. In this work, we developed and validated a novel and patented completely automated IMT measurement system called carotid measurement using dual snakes (CMUDS): a class of AtheroEdge system (Global Biomedical Technologies, Inc, Roseville, CA). CMUDS is modeled as a dual parametric system corresponding to LI and MA borders with initialization from the far adventitia layer. The novelty of CMUDS is the first‐order absolute moment–based external energy, which provides stable deformation. The dual snakes evolve simultaneously and are forced to maintain a regularized distance to prevent collapsing or bleeding. Two independent readers manually traced the LI/MA boundaries of a multi‐institutional, multi‐ethnic, and multi‐scanner database of 665 longitudinal images for performance evaluation. CMUDS was also benchmarked against a previously developed automated technique. CMUDS correctly processed 660 images (99.2% success). The differences between the CMUDS and two manual IMT measurements (mean ± SD) were 0.013 ± 0.216 and −0.021 ± 0.197 mm, respectively. The corresponding figures of merit for CMUDS compared to reader tracings were 98.4% and 97.5%. Compared to the previous technique (IMT differences, 0.022 ± 0.276 and −0.012 ± 0.266 mm), CMUDS improved accuracy (Wilcoxon P < 0.009) and variability (Fisher P < 10−8). Among different resolution images from original equipment manufacturer ultrasound scanners, CMUDS performed best with high‐resolution images corresponding to 0.0789 mm/pixel. Accuracy in IMT measurement with the proposed automated CMUDS technique makes this system adaptable to large multi‐center studies, in which such an IMT measurement system would be very useful tool.