Open AccessAortic root evaluation prior to transcatheter aortic valve implantation—Correlation of manual and semi-automatic measurements
Author(s) -
Barbora Horehledova,
Casper Mihl,
Chris Schwemmer,
Babs M. F. Hendriks,
Nienke G. Eijsvoogel,
B. Kietselaer,
Joachim E. Wildberger,
Marco Das
Publication year - 2018
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0199732
Subject(s) - intraclass correlation , semi automatic , fully automatic , aortic valve , prosthesis , perimeter , correlation coefficient , software , medicine , automation , limits of agreement , computer science , reproducibility , nuclear medicine , biomedical engineering , mathematics , surgery , statistics , mechanical engineering , geometry , engineering , programming language
Background Pre-procedural TAVI planning requires highly sophisticated and time-consuming manual measurements performed by experienced readers. Semi-automatic software may assist with partial automation of assessment of multiple parameters. The aim of this study was to evaluate differences between manual and semi-automatic measurements in terms of agreement and time. Methods One hundred and twenty TAVI candidates referred for the retrospectively ECG-gated CTA (2 nd and 3 rd generation dual source CT) were evaluated. Fully manual and semi-automatic measurements of fourteen aortic root parameters were assessed in the 20% phase of the R-R interval. Reading time was compared using paired samples t-test. Inter-software agreement was calculated using the Intraclass correlation coefficient (ICC) in a 2-way mixed effects model. Differences between manual and semi-automatic measurements were evaluated using Bland-Altman analysis. Results The time needed for evaluation using semi-automatic assessment (3 min 24 s ± 1 min 7 s) was significantly lower (p<0.001) compared to a fully manual approach (6 min 31 sec ± 1 min 1 sec). Excellent inter-software agreement was found (ICC = 0.93 ± 0.0; range:0.90–0.95). The same prosthesis size from manual and semi-automatic measurements was selected in 92% of cases, when sizing was based on annular area. Prosthesis sizing based on annular short diameter and perimeter agreed in 99% and 96% cases, respectively. Conclusion Use of semi-automatic software in pre-TAVI evaluation results in comparable results in respect of measurements and selected valve prosthesis size, while necessary reading time is significantly lower.