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Background Currently used techniques to quantify late gadolinium enhancement (LGE) include an intensity threshold 5 standard deviations (5-SD) above normal myocardium and the full width at half maximum (FWHM) of the histogram [1,2]. Validation of these segmentation schemes can be performed ex vivo using tetrazolium tetrachloride (TTC). However, no analogous gold standard metric exists in vivo. We recently introduced the tractographic propagation angle (PA) [3], and showed that a PA threshold of 4° in infarcted hearts produces a distribution that corresponds very closely to that of TTC staining [4]. Here, we use PA maps in patients with myocardial infarction (MI) to evaluate the standard FWHM and 5-SD metrics. In addition, we introduce a new metric based on a Gaussian fit of the LGE image histogram.

Infarct delineation in patients with acute myocardial infarction using the tractographic propagation angle and late gadolinium enhancement