Abstract
The purpose of this study was to evaluate the performance of a semiautomatic segmentation method for the anatomical and functional assessment of both ventricles from cardiac cine magnetic resonance (MR) examinations, reducing user interaction to a “mouse-click”. Fifty-two patients with cardiovascular diseases were examined using a 1.5-T MR imaging unit. Several parameters of both ventricles, such as end-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (EF), were quantified by an experienced operator using the conventional method based on manually-defined contours, as the standard of reference; and a novel semiautomatic segmentation method based on edge detection, iterative thresholding and region growing techniques, for evaluation purposes. No statistically significant differences were found between the two measurement values obtained for each parameter (p > 0.05). Correlation to estimate right ventricular function was good (r > 0.8) and turned out to be excellent (r > 0.9) for the left ventricle (LV). Bland-Altman plots revealed acceptable limits of agreement between the two methods (95%). Our study findings indicate that the proposed technique allows a fast and accurate assessment of both ventricles. However, further improvements are needed to equal results achieved for the right ventricle (RV) using the conventional methodology.
Highlights
Cardiovascular diseases are the leading cause of mortality in the western hemisphere
The difference in end-systolic volume (ESV) was close to statistical significance (p ≤ 0.05) but it was not considered clinically relevant (≥10 mL), according to the previously mentioned criteria
The mean difference observed between the parameters using both methods was −4.1 ± 19.0 mL for end-diastolic volume (EDV), −3.7 ± 13.5 mL for ESV, and 1.1 ± 7.0% for ejection fraction (EF) (Figure 3)
Summary
Cardiovascular diseases are the leading cause of mortality in the western hemisphere. In clinical practice, cardiac MR imaging with steady-state free precession (SSFP) cine sequences—which involves shorter scan time and higher image quality—emerges as the most precise and reproducible imaging technique for the evaluation of both left and right ventricular anatomy and function [5,6,7,8,9]: cardiac MR provides accurate quantitative information of ventricular size and function, blood flow measurements, myocardial viability, and cardiovascular anatomy; for these reasons, it is one of the preferred methods of imaging in patients with right ventricular diseases, such as, repaired Fallot’s tetralogy, arrhythmogenic right ventricular dysplasia, anomalous pulmonary venous return and pulmonary hypertension [10,11]
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