Protocol and quality assurance for carotid imaging in 100,000 participants of UK Biobank: development and assessment.

Journal article

Background

Ultrasound imaging is able to quantify carotid arterial wall structure for assessment of cerebral and cardiovascular disease risks. We describe a protocol and quality assurance process to enable carotid imaging at large scale that has been developed for the UK Biobank Imaging Enhancement Study of 100,000 individuals.

Design

An imaging protocol was developed to allow measurement of carotid intima-media thickness (CIMT) from the far wall of both common carotid arteries. Six quality assurance criteria were defined and a web-based interface (Intelligent Ultrasound) was developed to facilitate rapid assessment of images against each criterion.

Results and Conclusions

Excellent inter- and intra-observer agreements were obtained for image quality evaluations on a test dataset from 100 individuals. The image quality criteria then were applied in the UK Biobank Imaging Enhancement Study. Data from 2560 participants was evaluated. Feedback of results to the imaging team led to improvement in quality assurance (QA), with QA failures falling from 16.2% in the first two-month period examined to 6.4% in the last. 80% had all CIMT images graded as of acceptable quality, with at least one image acceptable for 98% of participants. CIMT measures showed expected associations with increasing age and gender.

Carotid imaging can be performed consistently, with semi-automated quality assurance of all scans, in a limited time frame within a large scale multimodality imaging assessment. Routine feedback of quality control metrics to operators can improve the quality of the data collection.

Authors: Coffey, S; Lewandowski, AJ; Garratt, S; Meijer, R; Lynum, S

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: SAGE Publications
• Journal: European Journal of Preventive Cardiology
• Publication date: 2017-09-01
• Acceptance date: 2017-08-27
• DOI: 10.1177/2047487317732273
• EISSN: 2047-4881
• ISSN: 2047-4873
• Pmid: 28925747
• Language: English
• Keywords: Carotid; ultrasound; UK Biobank; carotid intima-media thickness; carotid IMT; quality assurance