RT Journal Article SR Electronic T1 Computer-based quantification of the mean Achilles tendon thickness in ultrasound images: effect of tendinosis JF British Journal of Sports Medicine JO Br J Sports Med FD BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine SP 897 OP 902 DO 10.1136/bjsm.2007.037812 VO 41 IS 12 A1 R Syha A1 M Peters A1 H Birnesser A1 A Niess A1 A Hirschmueller A1 H-H Dickhuth A1 M Sandrock YR 2007 UL http://bjsm.bmj.com/content/41/12/897.abstract AB Background: B-mode measurement of the sagital diameter of the Achilles tendon based on a manual tracing (MT) procedure is partly dependent on the subjectivity of the reader. The aim of this study is to establish a standardised automatic procedure to differentiate between normal and chronically degenerated tendons. For this comparison, the tracing results of the tendon boundaries of an automatic identification (AI) process, already established with the detection of intima–media thickness, are compared with computer-assisted MT.Methods: The detection of the tendon boundaries was performed in 115 ultrasound images including the cranial border of the calcaneal tuberosity. The measured section (starting point 4 cm away from the anterior boundary of the calcaneal tuberosity) amounted to 3 cm, and was divided into three sub-segments (1 cm each). Intra- and inter-reader/observer variability for mean and maximum Achilles tendon thickness (ATT) with AI and MT were evaluated. A normal group and a group with clinically diagnosed chronic tendon degeneration had mean and maximum ATT readings compared.Results: Using MT, the intra- and inter-reader variability was 3.0% and 6.8%, respectively, using AI the variability was 1.6% and 3.9%, respectively. Mean and maximum ATT were measured systematically lower by AI compared to MT in all regions by 0.4 mm. The AI procedure was most accurate in the second segment. The mean ATT and maximum ATT were correctly detected in 93.9% and 96.6% of the images.Conclusion: The AI procedure detected the ATT with a high level of precision in all three segments. The most robust measurement was reached in the second segment. It eliminates most of the inter-/intra-reader variability in ATT measurement using MT. We suggest this new method could be a new gold standard for quantification of chronic disorder in Achilles tendons.