Left atrial structure and functional quantitation using cardiac magnetic resonance: comparison of manual delineation vs. multimodality tissue tracking based semi-automated methods

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Background Left atrium (LA) volume and function are important markers of cardiovascular disease. LA volume can be assessed by several different methods. In clinical practice, the Simpson’s method is well accepted as a reference standard, although there is no standardization for LA volume calculations. We aimed to compare the estimations of LA volume by the Simpson’s method and the modified biplane Simpson’s method; and to introduce Multimodality Tissue Tracking (MTT, Japan, Toshiba) as a new semi-automated method for quantifying LA function based on tissue feature tracking. Methods Thirty subjects (mean age: 71.3 ± 8.7, 87% male) including twenty subjects with cardiovascular events (4 atrial fibrillation, 18 myocardial scar from late gadolinium enhancement, 2 heart failure) and ten healthy subjects, with CMR imaging were evaluated in the Multi-Ethnic Study of Atherosclerosis (MESA). LA volumes were measured using the modified biplane Simpson’ sm ethod from 2- and 4-chamber projections and the original Simpson’s method using short-axis slices. For the manual methods, LA endo- and epicardial boundaries were delineated at left-ventricular end-diastole (Vmin), end-systole (Vmax) and just before the pre-atrial contraction (VpreA). Using MTT, LA endocardial and epicardial borders were manually delineated at end-systole and the boundaries were propagated automatically throughout the cardiac