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Myocardial infarct sizing by late gadolinium‐enhanced MRI: Comparison of manual, full‐width at half‐maximum, and n‐standard deviation methods
Author(s) -
ZHANG Lin,
HUTTIN Olivier,
MARIE PierreYves,
FELBLINGER Jacques,
BEAUMONT Marine,
CHILLOU Christian DE,
GIRERD Nicolas,
MANDRY Damien
Publication year - 2016
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.25285
Subject(s) - reproducibility , limits of agreement , nuclear medicine , medicine , standard deviation , bland–altman plot , full width at half maximum , magnetic resonance imaging , mathematics , radiology , materials science , statistics , optoelectronics
Purpose To compare three widely used methods for myocardial infarct (MI) sizing on late gadolinium‐enhanced (LGE) magnetic resonance (MR) images: manual delineation and two semiautomated techniques (full‐width at half‐maximum [FWHM] and n‐standard deviation [SD]). Materials and Methods 3T phase‐sensitive inversion‐recovery (PSIR) LGE images of 114 patients after an acute MI (2–4 days and 6 months) were analyzed by two independent observers to determine both total and core infarct sizes (TIS/CIS). Manual delineation served as the reference for determination of optimal thresholds for semiautomated methods after thresholding at multiple values. Reproducibility and accuracy were expressed as overall bias ± 95% limits of agreement. Results Mean infarct sizes by manual methods were 39.0%/24.4% for the acute MI group (TIS/CIS) and 29.7%/17.3% for the chronic MI group. The optimal thresholds (ie, providing the closest mean value to the manual method) were FWHM30% and 3SD for the TIS measurement and FWHM45% and 6SD for the CIS measurement (paired t ‐test; all P > 0.05). The best reproducibility was obtained using FWHM. For TIS measurement in the acute MI group, intra‐/interobserver agreements, from Bland–Altman analysis, with FWHM30%, 3SD, and manual were –0.02 ± 7.74%/–0.74 ± 5.52%, 0.31 ± 9.78%/2.96 ± 16.62% and –2.12 ± 8.86%/0.18 ± 16.12, respectively; in the chronic MI group, the corresponding values were 0.23 ± 3.5%/–2.28 ± 15.06, –0.29 ± 10.46%/3.12 ± 13.06% and 1.68 ± 6.52%/–2.88 ± 9.62%, respectively. A similar trend for reproducibility was obtained for CIS measurement. However, semiautomated methods produced inconsistent results (variabilities of 24–46%) compared to manual delineation. Conclusion The FWHM technique was the most reproducible method for infarct sizing both in acute and chronic MI. However, both FWHM and n‐SD methods showed limited accuracy compared to manual delineation. J. Magn. Reson. Imaging 2016;44:1206–1217.