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20 | Chapter 2 Abstract Introduction Ultrasonography is the most commonly used imaging modality for assessing subclinical atherosclerosis by measuring carotid intima media thickness (C-IMT) and plaques. C-IMT can be reliably measured using automated software, which is present on the portable Panasonic CardioHealth station (CHS). The aim of this study was to determine whether the CHS provides reliable and reproducible data in comparison with another automated software package present on the previously validated Philips iU22 (PiU). Methods and Results Carotid ultrasonography was performed by two experienced observers in 85 subjects. C-IMT was measured bilaterally from two different angles, and plaque scans were performed bilaterally. The intra-class correlation (ICC) of the C-IMT measurements was 0.98 (95% CI: 0.94-0.99) and 0,96 (95% CI: 0.89-0.99) for Observer X and Y, respectively. The ICC of the C-IMT between the two observers was 0.98 (95% CI: 0.95-0.99), and the limitsof agreement (LOA) were 0.007±0.040 mm (p=0.31). The ICC between both systems was 0.89 (95% CI: 0.81-0.93), and the LOA were 0.015±0.052 mm (p=0.03). Inter-observer agreement for the assessment of plaque was high on the CHS (kappa: 0.9±0.1, p=<0.001), and between systems (kappa: 1.0±0.0, p=<0.001). Conclusion The CHS has an excellent agreement with the validated PiU. The acquisition time of the CHS is shorter than that of the PiU. We conclude that the CHS is a rapid, reliable and precise method for assessing C-IMT and plaques, making it highly suitable for high- throughput screening and clinical use. Keywords • Carotid Intima Media Thickness • Intra-observer Variability • Inter-observer Variability