Characterization of 
carotid atherosclerosis and classification of plaque into symptomatic or 
asymptomatic along with the risk 
score estimation are key steps necessary for allowing the vascular surgeons to decide if the patient has to definitely undergo risky treatment procedures that are needed to unblock the 
stenosis. This application describes a statistical (a) 
Computer Aided Diagnostic (CAD) technique for symptomatic versus 
asymptomatic plaque automated classification of carotid 
ultrasound images and (b) presents a cardiovascular 
stroke risk 
score computation. We demonstrate this for longitudinal 
Ultrasound, CT, MR modalities and extendable to 3D carotid 
Ultrasound. The on-line 
system consists of Atherosclerotic Wall Region 
estimation using AtheroEdge™ for longitudinal 
Ultrasound or Athero-CTView™ for CT or Athero-MRView from MR. This greyscale Wall Region is then fed to a 
feature extraction processor which computes: (a) Higher Order Spectra; (b) 
Discrete Wavelet Transform (DWT); (c) Texture and (d) Wall Variability. The output of the Feature Processor is fed to the Classifier which is trained off-line from the 
Database of similar Atherosclerotic Wall Region images. The off-line Classifier is trained from the significant features from (a) Higher Order Spectra; (b) 
Discrete Wavelet Transform (DWT); (c) Texture and (d) Wall Variability, selected using t-test. Symptomatic 
ground truth information about the training patients is drawn from 
cross modality imaging such as CT or MR or 3D 
ultrasound in the form of 0 or 1. 
Support Vector Machine (SVM) supervised classifier of varying kernel functions is used off-line for training. The Atheromatic™ 
system is also demonstrated for Radial Basis 
Probabilistic Neural Network (RBPNN), or Nearest Neighbor (KNN) classifier or Decision Trees (DT) Classifier for symptomatic versus 
asymptomatic plaque automated classification. The obtained training parameters are then used to evaluate the 
test set. The 
system also yields the cardiovascular 
stroke risk 
score value on the basis of the four set of wall features.