Lal BK, et al. - Assuming the value of objective measures of plaque area and tissue composition from duplex ultrasound (DUS) images for the risk stratification of patients with a greater likelihood of future adverse events (stroke, transient ischemic attacks, or amaurosis fugax) and to assess the effect of vascular risk factor modification strategies (by measuring change in overall plaque burden and/or individual plaque tissue constituents), researchers examined DUS images of CREST-2 participants at baseline and determined the reliability of semiautomatic image processing to measure plaque area and tissue constituents. Findings suggested the feasibility and reproducibility of the semiautomatic protocol measuring plaque area, gray scale median, and tissue composition from B-mode ultrasound images in a randomized trial of asymptomatic patients with high-grade carotid stenosis.