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Aim To objectively determine the volume of damage measured by late Gadolinium enhancement (LGE) using threshold-free statistical fit to the distribution of image intensities to reflect the tissue heterogeneity, presence of noise and partial volume effects. Background Infarct size following STEMI carries prognostic significance. Current CMR methods for measuring abnormal myocardium are based on detecting pixels above a certain intensity threshold. This threshold is often defined from a ROI as the mean plus a number (nSD) of standard deviations. This method assumes that the ROI is “normal” and not affected by disease, and is sensitive both to the choice of the ROI and the nSD multiplier. Objective determination of the volume of damage on LGE images may be desirable. Material and methods 17 STEMI patients aged 56±9 years underwent 3T CMR imaging within 48h post PCI using a phase-sensitive late-gadolinium enhanced inversion recovery (PSIR) method. Histograms of myocardial signal intensities were calculated in each patient and fitted with a sum of two Gaussians. We calculated the relative volume fraction (VfGauss) as the area under the Gaussian distribution with the higher peak divided by the total area under both peaks. For comparison, traditional threshold segmentation was performed based on ROI placed in remote myocardium and varying the threshold nSD

journal of cardiovascular magnetic resonance

Gaussian modelling for operator-independent and threshold-free volumetric segmentation of phase sensitive inversion recovery late gadolinium enhanced images