Can Different Expertise Levels of Ultrasound Operators Accurately Screen with Handheld Ultrasound?

Objective: To evaluate accuracy and feasibility of a handheld ultrasound machine for measuring carotid artery intima-media thicknesses (CIMT) and hemodynamic parameters by different expertise levels of ultrasound operators. Methods: The operators were divided into three groups based on the level of their medical expertise: ultrasound technician, sonographer, and nursing staff. Operators from each group measured the CIMT and hemodynamic parameters of 25 volunteers using both handheld ultrasound and a conventional ultrasound machine. The reliability and reproducibility of handheld ultrasound measurements of CIMT and hemodynamic parameters (peak systolic velocity (PSV), end-diastolic velocity (EDV)) in operators were analyzed. Results: After a period of training, there was no statistically significant difference between the mean CIMT measured using handheld ultrasound among the three operators (0.45 ± 0.09 mm, 0.50 ± 0.07 mm, 0.46 ± 0.08 mm, P> 0.05, respectively), as well as PSV (83.30 ± 15.42 cm/s, 76.28 ± 13.26 cm/s, 81.12 ± 21.21 cm/s, P> 0.05, respectively) and EDV (21.04 ± 4.12 cm/s, 21.87 ± 5.05 cm/s, 20.17 ± 5.90 cm/s, respectively, P> 0.05). Furthermore, there was a good repeatability and consistent of handheld ultrasound device in measuring mean CIMT in the ultrasound technician and sonographer groups (r = 0.662, 0.691, respectively, P < 0.01). Conclusions: Under the premise of proper training, handheld ultrasound systems are feasible for rapid and primary assessment of carotid artery by operators with different levels of expertise.