Clinical feasibility of a myocardial signal intensity threshold-based semi-automated cardiac magnetic resonance segmentation method

Varga-Szemes, Ákos; Muscogiuri, Giuseppe; Schoepf, U. Joseph; Wichmann, Julian L.; Surányi, Pál; Cecco, Carlo N. De; Cannaò, Paola Maria; Renker, Matthias; Mangold, Stefanie; Fox, Mary A.; Ruzsics, Balázs

doi:10.1007/s00330-015-3952-4

Cited by 40 publications

(28 citation statements)

References 31 publications

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“…TB-method surpassed the first method significantly with G-ICC scores of over 0.9. The threshold-based method has improved accuracy comparing aortic flow measurement as a reference [20]; accordingly, our data proved excellent equality of left and right ventricular stroke volumes with TB analysis compared to the conventional method.…”

Section: Discussionsupporting

confidence: 51%

“…The algorithm has improved accuracy evaluating left ventricular volumetric parameters compared to flow measurement as a reference [20]. TB quantification also reported less time consuming than conventional (Conv) method regarding LV evaluation [20].…”

Section: Introductionmentioning

confidence: 98%

“…The software could delineate the myocardium from blood pool based on their different signal intensities in the absence of endocardial contour [20]. The algorithm has improved accuracy evaluating left ventricular volumetric parameters compared to flow measurement as a reference [20].…”

Section: Introductionmentioning

confidence: 99%

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Left and right ventricular parameters corrected with threshold-based quantification method in a normal cohort analyzed by three independent observers with various training-degree

Csécs

Czimbalmos

Suhai

et al. 2018

Int J Cardiovasc Imaging

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While cardiac magnetic resonance (CMR) is the reference method to evaluate left and right ventricular functions, volumes and masses, there is no widely accepted method for the quantitative analysis of trabeculae and papillary muscles (TPM). The aim of this study was to investigate the effect of TPM quantification on left and right ventricular CMR values in a normal cohort and to investigate interobserver variability of threshold-based (TB) analysis by three independent observers with variant experience in CMR. At our clinic, 60 healthy volunteers (30 males, mean age 25.6 ± 4.7 years) underwent CMR scan performed on a 1.5T Philips Achieva MR machine. On short-axis cine images, endo-and epicardial contours were detected by three independent observers with variable experience in CMR (low-ca. 120, mid-> 800, high-experienced > 5000 original CMR cases). Using Conv and TB methods (Medis 7.6 QMass software Leiden, The Netherland), we measured LV and RV ejection fractions, end-diastolic, end-systolic, stroke volumes and masses. We used TB method for quantifying TPM in ventricles using epicardial contour layers. Interobserver variability was evaluated, and the observer's experience as an impact on variability of each investigated parameters was assessed. Comparing Conv and TB quantification methods' significant difference were detected for all LV and RV parameters in case of all observers (H, M and L p < 0.0001). The global intraclass correlation coefficient (G-ICC) representing interobserver agreement for all investigated parameters was lower with Conv method (G-ICC Conv vs. G-ICC TB 0.86 vs. 0.92 p < 0.0001). The ICC of LV parameters was higher using TB quantification (LV-ICC Conv vs. LV-ICC TB 0.92 vs. 0.96 p < 0.0001), and for the evaluation of RV values, the TB method also had significantly higher interobserver agreement (RV-ICC Conv vs. RV-ICC TB 0.80 vs. 0.89 p < 0.0001). The TB algorithm could be a consistent method to assess LV and RV CMR values, and to measure trabeculae and papillary muscles quantitatively in various level of experience in CMR.

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Section: Discussionsupporting

confidence: 51%

Section: Introductionmentioning

confidence: 98%

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Left and right ventricular parameters corrected with threshold-based quantification method in a normal cohort analyzed by three independent observers with various training-degree

Csécs

Czimbalmos

Suhai

et al. 2018

Int J Cardiovasc Imaging

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“…Therefore, other segmentation methods have been developed to decrease these errors ( 4 5 6 7 8 9 10 11 12 13 14 15 ). Of these, a threshold-based segmentation is an effective method separating the ventricular cavity from the myocardium which includes the papillary muscles and trabeculations based on pixel or voxel signal intensities ( 7 8 9 11 12 13 14 15 ). In addition, a three-dimensional (3D) analysis can avoid an error (about 20%) caused by disc summation of 2D slices ( 16 ).…”

Section: Introductionmentioning

confidence: 99%

Comparison between Three-Dimensional Navigator-Gated Whole-Heart MRI and Two-Dimensional Cine MRI in Quantifying Ventricular Volumes

Goo

2018

Korean J Radiol

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ObjectiveTo test whether the method utilizing three-dimensional (3D) whole-heart MRI has an additional benefit over that utilizing conventional two-dimensional (2D) cine MRI in quantifying ventricular volumes.Materials and MethodsIn 110 patients with congenital heart disease, a navigator-gated, 3D whole-heart MRI during end-systole (ES) and end-diastole (ED), 2D short-axis cine MRI, and phase contrast MRI of the great arteries were acquired. Ventricular volumes were measured by using a 3D threshold-based segmentation for 3D whole-heart MRI and by using a simplified contouring for 2D cine MRI. The cardiac trigger delays of 3D whole-heart MRI were compared with those of a 2D cine MRI. The stroke volumes calculated from the ventricular volumes were compared with the arterial flow volumes, measured by phase contrast MRI.ResultsThe ES and ED trigger delays of whole-heart MRI were significantly less than cine MRI for both the left ventricle (−16.8 ± 35.9 ms for ES, −59.0 ± 90.4 ms for ED; p < 0.001) and the right ventricle (−58.8 ± 30.6 ms for ES, −104.9 ± 92.7 ms for ED; p < 0.001). Compared with the arterial flow volumes, 2D cine MRI significantly overestimated the left ventricular stroke volumes (8.7 ± 8.9 mL, p < 0.001) and the 3D whole-heart MRI significantly underestimated the right ventricular stroke volumes (−22.7 ± 22.9 mL, p < 0.001).ConclusionThree-dimensional whole-heart MRI is often subject to early timing of the ED phase, potentially leading to the underestimation of the right ventricular stroke volumes.

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“…Cardiac magnetic resonance (CMR) has gained a crucial role in adults with DCM, since CMR provides reliable information about cardiac function and muscle tissue characterization ( 5 ). In fact, CMR is able to evaluate with great accuracy regional left ventricle (LV) wall motion, global systolic function, and presence of myocardial fibrosis ( 6 , 7 ). Late gadolinium enhancement (LGE) imaging enables identification and quantification of areas of myocardial fibrosis.…”

Section: Introductionmentioning

confidence: 99%

Results of Late Gadolinium Enhancement in Children Affected by Dilated Cardiomyopathy

et al. 2017

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BackgroundLittle is known about the clinical value of late gadolinium enhancement (LGE), in children affected by dilated cardiomyopathy (DCM).Materials and methodsWe retrospectively evaluated 15 patients (8 ± 6 years, 6 males) with diagnosis of DCM who underwent cardiac magnetic resonance since 2014. All scans were performed with a 1.5 T system (Aera, Siemens). Study protocol included cine steady-state free precession sequences, followed by administration of 0.2 mmol/kg of gadolinium-based contrast agent. Inversion recovery Turbo Flash sequences, in the same position of cine images, were acquired 10–15 min after the injection of contrast agent, in order to assess the presence of LGE. The latter was considered positive with a signal intensity >6 SD from normal myocardial tissue. Indexed end-diastolic volume (EDVi) and end-systolic volume (ESVi), and left ventricle (LV) ejection fraction (EF) were calculated by using dedicated software on off-line workstation. Global longitudinal strain and diastolic function were evaluated by echocardiography. Clinical follow-up, including death, transplant, and listing for heart transplant [major adverse cardiac events (MACE)], were evaluated. Patients were divided into two different subgroups: negative (Group A) and positive (Group B) for presence of LGE. Statistical analysis was performed by using Mann–Whitney U test (p < 0.05 considered as statistically significant).ResultsSeven patients (47%) showed LGE. A global diffuse subendocardial pattern was evident in all patients presenting LGE (7/7, 100%). The following main LV indexes were observed in the two subgroups. Group A: EDVi = 96 ± 33 ml, ESVi = 56 ± 29 ml, LV EF = 45 ± 10%, global longitudinal strain = −16 ± 5%, E/e′ ratio = 10 ± 3, MACE = 1. Group B: EDVi = 130 ± 60 ml, ESVi = 89 ± 43 ml, LV EF = 31 ± 6%, global longitudinal strain = −13 ± 4%, E/e′ ratio = 9 ± 3, MACE = 3. There was no statistically significant difference between the two groups, in terms of EDVi (p: 0.2), ESVi (p: 0.2), and E/e′ ratio (0.9), whereas a significant difference of LV EF, presence of significative mitral regurgitation, and global longitudinal strain were observed (respectively, p: 0.03, p: 0.009, and p: 0.03).ConclusionIn our population of children with DCM, LGE shows a global diffuse subendocardial pattern. Presence of LGE seems to play a role in these patients determining a worst global systolic function.

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Clinical feasibility of a myocardial signal intensity threshold-based semi-automated cardiac magnetic resonance segmentation method

Cited by 40 publications

References 31 publications

Left and right ventricular parameters corrected with threshold-based quantification method in a normal cohort analyzed by three independent observers with various training-degree

Left and right ventricular parameters corrected with threshold-based quantification method in a normal cohort analyzed by three independent observers with various training-degree

Comparison between Three-Dimensional Navigator-Gated Whole-Heart MRI and Two-Dimensional Cine MRI in Quantifying Ventricular Volumes

Results of Late Gadolinium Enhancement in Children Affected by Dilated Cardiomyopathy

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