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Rapid and accurate left ventricular chamber quantification using a novel CMR segmentation algorithm: A clinical validation study
Author(s) -
Codella Noel C.F.,
Cham Matthew D.,
Wong Richard,
Chu Christopher,
Min James K.,
Prince Martin R.,
Wang Yi,
Weinsaft Jonathan W.
Publication year - 2010
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.22080
Subject(s) - ejection fraction , ventricle , stroke volume , medicine , nuclear medicine , cardiology , systole , metric (unit) , algorithm , diastole , mathematics , heart failure , blood pressure , operations management , economics
Purpose: To evaluate the clinical performance of a novel automated left ventricle (LV) segmentation algorithm (LV‐METRIC) that involves no geometric assumptions. Materials and Methods: LV‐METRIC and manual tracing (MT) were used independently to quantify LV volumes and LVEF (ejection fraction) for 151 consecutive patients who underwent cine‐CMR (steady‐state free precession). Phase contrast imaging was used to independently measure stroke volume. Results: LV‐METRIC was successful in all cases. Mean LVEF was within 1 point of MT (Δ 0.6 ± 2.3%, P < 0.05), with smaller differences among patients with (0.5 ± 2.5%) versus those without (0.9 ± 2.3%; P = 0.01) advanced systolic dysfunction (LVEF ≤ 35% by MT). LV volumes by LV‐METRIC were slightly smaller than MT during end‐diastole (3.9 ± 6.8 mL, P < 0.001) and end‐systole (1.4 ± 5.5 mL, P < 0.01). Mean processing time was 22 ± 13 seconds for LV‐METRIC and 4:59 ± 1:56 minutes for MT ( P < 0.001). Processing time correlated with LV blood volume by MT ( r = 0.43) and LV‐METRIC ( r = 0.55), but slope was 10‐fold steeper for MT (0.02 vs. 0.001), indicating greater proportionate time increases in relation to chamber dilation. Compared to stroke volume by phase contrast, LV‐METRIC yielded smaller differences (0.3 ± 18.3 mL) than MT (2.5 ± 17.2 mL; P < 0.001). Conclusion: Among a broad series of consecutive patients undergoing CMR, automated LVEF by LV‐METRIC was within 1 point of MT with processing time reduced 14‐fold. Stroke volume by LV‐METRIC yielded improved agreement with an independent standard of phase contrast imaging. J. Magn. Reson. Imaging 2010;31:845–853. ©2010 Wiley‐Liss, Inc.