Connie,

I actually have had a few discussions with Dr. Stein as well as the actual 
developer of some specific IMT software, thank you. I am also well versed in 
the history, development, implementation, performance and shortfalls/pitfalls 
of Carotid IMT Scanning. 

With all due respect, if you are seriously researching IMT in children, (which I 
find most interesting and admirable...so do a bunch of Finnish physicians :O) ), 
especially the ones with a history/family history of hypercholesterolemia, why 
would you not use available software? Why continue to use a "challenging" 
technique such as measuring IMT freehand which has been proven to not be 
nearly as reliable, accurate, and reproducible as newer technology? Accuracy 
is the key. 

I don't care how seasoned you may be, you are not going to 
get "reproducible"  aggregate accuracy to the 100th of a millimeter using 
manual measuring techniques.

Rob

On Wed, 30 Jan 2008 09:10:35 -0500, Connie McCoy <[log in to unmask]> 
wrote:

>Rob,
>I do not use a specific software to measure IMT.  I am researching IMT in 
Kids and if you talk to Dr. Stein I am sure he would tell you that his folks at 
Univ of Wisconsin did not use software until it was felt it could be developed 
and marketed for the clinical/screening arena.
>I agree measuring IMT is not for the novice.  I feel I am a very seasoned 
vascular sonographer and measuring IMT, free form, is another challenge.
>Though, it can be done with reproducibility.
>Connie McCoy, RVT
>Cincinnati Children's Hospital
>
>-----Original Message-----
>From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of 
SUBSCRIBE UVMFLOWNET robert rosner
>Sent: Tuesday, January 29, 2008 10:05 PM
>To: [log in to unmask]
>Subject: Re: CIMT
>
>Oh yes, Audrey, how foolish of me to forget that these other tools are at our
>disposal! ;o)
>
>I did try using a fishing depthfinder for my initial studies, but the patients who
>looked over at the screen saw little fishies instead of plaque formations. They
>were disturbed about the images. Oh, how silly I was back then.
>
>On Tue, 29 Jan 2008 18:26:59 -0800, Audrey Fleming
><[log in to unmask]> wrote:
>
>>Ahh come on Rob, hand grenades, horseshoes, and sonography....all you
>need is to get close enough for it to count..........<ducking>
>>
>>SUBSCRIBE UVMFLOWNET robert rosner <[log in to unmask]> wrote:   I
>would say that measuring Carotid IMT without specialized edge-detection
>>software that is bundled with included gender/age/race graphs that have
>been
>>developed in the course of 20+ years of clinical research should be
>>discouraged, to say the least.
>>
>>The most commonly conducted Carotid IMT test requires 3 measurements
>from
>>each distal 1cm segment of the CCA using 3 specific angulation parameters.
>>Each measurement consists of about a 1cm segment of the intima-media and
>>would account for about 100-120 simutaneous AP measurments that are
>>analysed and averaged into the other 5 sites. A final patient specific report 
is
>>then generated using the IMT software. Thus, you should be taking
>>approximately 600-720 dead-on-balls accurate measurements of these 6
>sites.
>>
>>If you are NOT doing at least this for your patients, then you are doing them
>a
>>great disservice.
>>
>>RR
>>
>>On Tue, 29 Jan 2008 11:35:36 -0600, Lygia Waters
>>wrote:
>>
>>>
>>>Hi, is anyone out there measuring CIMT without using a specific software
>>program? If so, how? If not, why not?
>>>
>>>Thanks!
>>>
>>>L.Waters, RVT
>>>_______________________________________________________________
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