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Background Infarct size is increasingly used as an efficacy endpoint in randomized trials comparing acute myocardial infarct (AMI) therapies. Infarct size, depicted by delayedenhancement-CMR, is quantified using manual planimetry (MANUAL), visual scoring (VISUAL), or automated techniques using signal-intensity thresholding to define infarct borders (AUTO). Although AUTO is considered the most reproducible, prior studies did not account for the subjective determination of endocardial/epicardial borders, which all methods require. For MANUAL and VISUAL, prior studies have not explicitly defined how to treat intermediate signal-intensities due to partial volume. We wanted to assess sources of variability among 6 methods in quantification of AMI size, and illustrate the significance of these findings on sample size calculations for clinical trials.

journal of cardiovascular magnetic resonance

Sources of variability in quantification of CMR infarct size and their impact on sample size calculations - reproducibility among three core laboratories