Full Width At Half Maximum Method Research Articles

Evaluation of deep learning-based reconstruction late gadolinium enhancement images for identifying patients with clinically unrecognized myocardial infarction

BackgroundThe presence of infarction in patients with unrecognized myocardial infarction (UMI) is a critical feature in predicting adverse cardiac events. This study aimed to compare the detection rate of UMI using conventional and deep learning reconstruction (DLR)-based late gadolinium enhancement (LGEO and LGEDL, respectively) and evaluate optimal quantification parameters to enhance diagnosis and management of suspected patients with UMI.MethodsThis prospective study included 98 patients (68 men; mean age: 55.8 ± 8.1 years) with suspected UMI treated at our hospital from April 2022 to August 2023. LGEO and LGEDL images were obtained using conventional and commercially available inline DLR algorithms. The myocardial signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and percentage of enhanced area (Parea) employing the signal threshold versus reference mean (STRM) approach, which correlates the signal intensity (SI) within areas of interest with the average SI of normal regions, were analyzed. Analysis was performed using the standard deviation (SD) threshold approach (2SD–5SD) and full width at half maximum (FWHM) method. The diagnostic efficacies based on LGEDL and LGEO images were calculated.ResultsThe SNRDL and CNRDL were two times better than the SNRO and CNRO, respectively (P < 0.05). Parea−DL was elevated compared to Parea−O using the threshold methods (P < 0.05); however, no intergroup difference was found based on the FWHM method (P > 0.05). The Parea−DL and Parea−O also differed except between the 2SD and 3SD and the 4SD/5SD and FWHM methods (P < 0.05). The receiver operating characteristic curve analysis revealed that each SD method exhibited good diagnostic efficacy for detecting UMI, with the Parea−DL having the best diagnostic efficacy based on the 5SD method (P < 0.05). Overall, the LGEDL images had better image quality. Strong diagnostic efficacy for UMI identification was achieved when the STRM was ≥ 4SD and ≥ 3SD for the LGEDL and LGEO, respectively.ConclusionsSTRM selection for LGEDL magnetic resonance images helps improve clinical decision-making in patients with UMI. This study underscored the importance of STRM selection for analyzing LGEDL images to enhance diagnostic accuracy and clinical decision-making for patients with UMI, further providing better cardiovascular care.

Comparative analysis of late gadolinium enhancement assessment techniques for monitoring fibrotic changes in myocarditis follow-up.

To compare the repeatability and interrelation of various late gadolinium enhancement (LGE) assessment techniques for monitoring fibrotic changes in myocarditis follow-up. LGE extent change between baseline and 3-month cardiovascular magnetic resonance (CMR) was compared in patients with acute myocarditis using the full width at half maximum (FWHM), gray-scale thresholds at 5 and 6 standard deviations (SD5 and SD6), visual assessment with threshold (VAT) and full manual (FM) techniques. In addition, visual presence score (VPS), visual transmurality score (VTS), and a simplified visual change score (VCS) were assessed. Intraclass-correlation (ICC) was used to evaluate repeatability, and methods were compared using Spearman's correlation. Forty-seven patients (38 male, median age: 27 [IQR: 21; 38] years) were included. LGE extent change differed among quantitative techniques (p < 0.01), with variability in the proportion of patients showing LGE change during follow-up (FWHM: 62%, SD5: 74%, SD6: 66%, VAT: 43%, FM: 60%, VPS: 53%, VTS: 77%, VCS: 89%). Repeatability was highest with FWHM (ICC: 0.97) and lowest with SD5 (ICC: 0.89). Semiquantitative scoring had slightly lower values (VPS ICC: 0.81; VTS ICC: 0.71). VCS repeatability was excellent (ICC: 0.93). VPS and VTS correlated with quantitative techniques, while VCS was positively associated with VPS, VTS, VAT, and FM, but not with FWHM, SD5, and SD6. FWHM offers the least observer-dependent LGE follow-up after myocarditis. VPS, VTS, and VCS are practical alternatives, showing reliable correlations with quantitative methods. Classification of patients exhibiting either stable or changing LGE relies on the assessment technique. This study shows that LGE monitoring in myocarditis is technique-dependent; the FWHM method yields the most consistent fibrotic tracking results, with scoring-based techniques as reliable alternatives. Recognition of fibrotic changes during myocarditis follow-up is significantly influenced by the choice of the quantification technique employed. The FWHM technique ensures highly repeatable tracking of myocarditis-related LGE changes. Segment-based visual scoring and the simplified visual change score offer practical, reproducible alternatives in resource-limited settings.

Analysis of retinal arteriolar and venular parameters in primary open angle glaucoma.

To measure the retinal vessels of primary open angle glaucoma (POAG) patients on spectral domain optical coherence tomography (SD-OCT) with a full-width at half-maximum (FWHM) algorithm to better explore their structural changes in the pathogenesis of POAG. In this retrospective case-control study, the right eyes of 32 patients with POAG and 30 healthy individuals were routinely selected. Images of the supratemporal and infratemporal retinal vessels in the B zones were obtained by SD-OCT, and the edges of the vessels were identified by the FWHM method. The internal and external diameters, wall thickness (WT), wall cross-sectional area (WCSA) and wall-to-lumen ratio (WLR) of the blood vessels were studied. Compared with the healthy control group, the POAG group showed a significantly reduced retinal arteriolar outer diameter (RAOD), retinal arteriolar lumen diameter (RALD) and WSCA in the supratemporal (124.22±12.42 vs 138.32±10.73 µm, 96.09±11.09 vs 108.53±9.89 µm, and 4762.02±913.51 vs 5785.75±1148.28 µm2, respectively, all P<0.05) and infratemporal regions (125.01±15.55 vs 141.57±10.77 µm, 96.27±13.29 vs 110.83±10.99 µm, and 4925.56±1302.88 vs 6087.78±1061.55 µm2, all P<0.05). The arteriolar WT and WLR were not significantly different between the POAG and control groups, nor were the retinal venular outer diameter (RVOD), retinal venular lumen diameter (RVLD) or venular WT in the supratemporal or infratemporal region. There was a positive correlation between the arteriolar parameters and visual function. In POAG, narrowing of the supratemporal and infratemporal arterioles and a significant reduction in the WSCA is observed, while the arteriolar WT and WLR do not change. Among the venular parameters, the external diameter, internal diameter, WT, WLR, and WSCA of the venules are not affected.

On the Estimation of Resonance Widths of Field Line Resonances Using Ground Magnetometer Data

This paper presents a comparison of three methods to estimate the latitudinal resonance width of field line resonant, ultra-low frequency waves detected at the ground. These are a spatial domain, full-width half-maximum method and frequency domain amplitude-phase and amplitude-division methods. These methods were used to estimate the resonance width of several field line resonant intervals occurring on 26 November 2001, 1 October 2012, and 19 June 2015. The 19 June 2015 interval used data from one low, two mid, and one high latitudes. It was found that the resonance width estimates were different for each method and with how the data were processed. The most suitable methods and data processing were determined from a damped driven harmonic oscillator model. The amplitude-division methods yielded the most accurate results when the ground magnetic field data were processed with a boxcar window function or a frequency domain, exponential smoothing taper. The amplitude-phase method tended to underestimate the resonance width. The full-width half-maximum method gave accurate results for a high spatial resolution linear piece-wise curve fitted to the spectral amplitude with latitude profile. An accurate estimate of the latitudinal resonance width requires a correct choice of data processing, estimate method, resonance profile with latitude, and resonance model.

Looking for appropriate criterias for SCD prevention: prognostic role of MRI in patients with nonischemic ventricular arrhythmias

Abstract Background Currently left ventricular ejection fraction (LVEF) remains the only indicator for identifying candidates for implantable cardioverter-defibrillator (ICD)therapy for the primary prevention of sudden cardiac death (SCD). However the majority of patients suffering SCD have a preserved LVEF and some of them with poor LVEF do not benefit from ICD therapy. Late gadolinium enhancement (LGE) on cardiac-MRI (CMR) has been proposed as an independent predictor of ventricular arrhythmias. Limited data exist on the role and methods of LGE quantification in patients with a nonischemic ventricular arrhythmias. Purpose The goal of this study is to explore whether theextent of LGE would improve risk stratification in patients with a nonischemic ventricular arrhythmias with an indication for implantable cardioverter-defibrillator (ICD) therapy for the primary or secondary prevention of SCD. Methods Fifty six patients with a nonischemic ventricular arrhythmias underwent LGE-CMR prior to ICD implantation for primary and secondary prevention of SCD. LGE extent was quantified using both the full-width half-maximum (FWHM) andthe standard deviation–based (2-SD) method. The primary endpoint was appropriate ICD discharge for sustained ventricular tachyarrhythmia. Results During a median follow-up of 18 [11,5–26,0] months the primary endpoint occurred in 22 patients. The median percentage of LV myocardium fibrosis assessed by the 2-SD method was 9,8 [6,0–18,8]%, while for the FWHM method it was 5,1 [3,0–10,6]% (p&amp;lt;0,001). Intra-observer and inter-observer variability of the FWHM technique was excellent, intraclass correlation coefficients (ICC) 0,97 (95% CI: 0,92–0,99) for intraobserver variability and 0,95 (95% CI: 0,85–0,98) for interobserver variability. The ICC for the 2-SD method were lower: 0,92 (95% CI: 0,76–0,97) and 0,90 (95% CI: 0,69–0,96), for intra- and interobserver variability, respectively. By Cox univariate regression analysis, past syncope, HR: 3,14; (CI: 1,28–7,73), past sustained VT, HR: 8,24; (CI: 2,43–27,96), the presence of LBBB before implantation cardiac resynchronization therapy defibrillator (CRT-D), HR: 0,22; (CI: 0,05–0,96) as well as extent of LGE, HR: 1,067; per 1% increase in the extent of LGE, (CI: 1,029–1,107) demonstrated the strongest association with the appropriate ICD discharge. In multivariate regression analysis, the history of sustained VT, HR: 9,17; (CI: 2,60–32,38; p=0,001) and the value of the extent of LGE, HR: 1,081; per 1% increase in volume of LGE, (CI: 1,034–1,131; p=0,001) demonstrated an independent association with the appropriate ICD discharge. Conclusions FWHM is the optimal semi-automated quantification method in patients with nonischemic ventricular arrhythmias, demonstrating the highest technical consistency. LGE extent is an independent predictor of adverse outcomes in patients with nonischemic ventricular arrhythmia and may have an important role in risk stratification. Funding Acknowledgement Type of funding sources: None. LGE QuantificationEvent-Free Survival

Myocardial fibrosis quantification methods by cardiovascular magnetic resonance imaging with contrast-enhancement in patients with Fabry disease

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): National Agency for Academic Exchange (NAWA). Background. Presence and extent of late gadolinium enhancement (LGE) in patients with Fabry disease (FD) is a predictor of adverse cardiac events. However there is no gold standard method to quantify the amount of myocardial fibrosis in cardiac magnetic resonance imaging (CMR). Purpose. The aim of this study was to establish the most reliable and reproducible technique for quantifying LGE in patients with FD. Methods. 68 patients with FD (40% male, 40 ± 16 years old) treated in our outpatient clinic, who underwent CMR with administration of 0.2 mmol of gadobutrol per kilogram of body weight between December 2012 and March 2019 were enrolled into the study. Presence of LGE was described in 25 patients (37%). Twenty patients underwent CMR with the same LGE sequence (Philips 1.5 Tesla, two-dimensional multi-breath-hold inversion recovery sequence) and were enrolled into further analysis. LGE quantifications were performed using gray-scale thresholds with 2, 3, 4, 5 and 6 standard deviations (SD) above the mean signal intensity for the remote myocardial tissue, full width at half maximum method (FWHM), visual assessment with threshold (VAT) and fully manual method (MM; Philips IntelliSpace Portal 10). LGE quantifications were done twice by the same observer in different time periods and once by another observer. Intraclass correlation coefficient (ICC), Bland- Altman analysis and coefficient of variation (CV) were used to assess intra- and interobserver reliability and reproducibility. Results. The mean quantity of fibrosis mass (in gram) in all studied patients was: 35.5 ± 18.7 at 2SD, 21.0 ± 12.8 at 3SD, 12.7 ± 8.5 at 4SD, 8.0 ± 5.7 at 5SD, 5.3 ± 4.1 at 6SD, 1.9 ± 1.8 at FWHM, 8.6 ± 7.4 at VAT and 9.1 ± 6.1 at MM. Intra-observer reliability of almost all studied LGE quantification methods was excellent, with a range of ICCs from 0.90 for 6SD to 0.95 for VAT, with one exception for FWHM, which had good intraobserver reliability (ICC 0.84; all P &amp;lt; 0.05). Interobserver reliability was excellent for VAT (ICC 0.94) and good for all other LGE quantifications methods (range of ICCs from 0.76 for MM to 0.87 for 5SD, all P &amp;lt; 0.05). 5SD had the lowest CV (6%) for intraobserver reproducibility and 2SD and VAT for interobserver reproducibility (35% and 38%). FWHM had the highest CV for both intra- and interobserver reproducibility (63% and 94%, accordingly). Conclusions 1. All studied methods of LGE quantification in patients with FD and presence of myocardial fibrosis have good to excellent intra- and interobserver reliability. 2. The total amount of LGE differs in studied LGE quantifications methods. Therefore in clinical practice it is important to report which technique of LGE quantification was used and choose the same for CMR-follow up. 3. FWHM might be avoided for LGE quantification in patients with FD due to the highest intra- and interobserver variability in comparison to other available techniques.

Effect of temperature and wavelength on the refractive index of water: a fiber-optic sensor application

The refractive index \(n(\lambda ,T\)) is a basic optical property of materials. The refractive index and the thermo-optic coefficient (\({\mathrm{d}}n/{\mathrm{d}}T\)) are significant parameters of liquids for optically controlled systems, such as the direct measurement of liquid solution concentrations and optical paths. In this study, the variation in the refractive index of water in the liquid phase with temperature was measured with our self-designed fiber optic-based refractive index sensor and \({\mathrm{d}}n/{\mathrm{d}}T\) values were obtained with a full-width half-maximum method at wavelengths of 980, 1426, and 1550 nm, respectively. Water is the most abundant and life-critical substance in the world, and its optical properties pose challenging scientific problems that require knowledge of the refractive index to be resolved. The results indicate that the experimental refractive index values are compatible with both the theoretical and experimental data in the literature. We also tested the refraction index results with two theoretical models and obtained good agreement between the calculated and experimental values. The resolution of the fiber optic-based refractive index sensor was 10\(^{-5}\). Our designed sensor could measure the refractive index of liquids with temperature with accuracy.

Determination of scar area using native and post contrast T1 mapping: a validation study

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Goethe University Hospital Introduction Late gadolinium enhancement (LGE) with Full Width Half Maximum (FWHM) is the standard imaging method for the measurement of the scar area in ischemic heart disease, a major determinant of adverse outcome. T1 mapping techniques have become increasingly applied in everyday clinical practice. Agreement in area quantification between T1 mapping and LGE for the scar extent has not been systematically assessed. Purpose This study aims to ascertain concordance between the area determined by native and post contrast T1 mapping against LGE to determine scar area in patients with a prior myocardial infarction. It also examines intra and inter-observer reproducibility for these two methods. Methods Subendocardial scar was evaluated in 132 patients with ischemic heart disease using LGE, native and post contrast T1 mapping in 3 short axis slices. Native and postcontrast T1 mapping was performed using GoetheCVI®MOLLI sequence (Gadovist® 0.1mmol/kg). FWHM method was applied for LGE and compared with the manually delineated area of scar in native and postcontrast T1 mapping acquisitions within the identical slices. The presence of the scar was defined as LGE &amp;gt;3% of the myocardial mass. Bland-Altman methods were employed to assess concordance between techniques and reproducibly between observers. Results In comparison to LGE, area measurements in native T1 acquisitions underestimated infarct size (9,1% vs 12,6%, p = 0.01), while postcontrast T1 overestimated it (19,4% vs 12,6%, p &amp;lt; 0.001). The disparity between the measurements was accentuated with larger scar areas (Figure 1). Intraobserver reproducibility (native T1: intra/inter MD ± SD, CoV, postcontrast T1: intra/inter) was similar with both methods, whereas interobserver variability for native T1 mapping acquisition was worse. Conclusions We demonstrate that measurements of the area of myocardial scar by T1 mapping acquisitions yield considerably different results in comparison to the standard LGE-based FWHM method. High observer agreement indicates that these differences are genuinely related to the type of the underlying acquisition and the differences in detected signal. The approaches are not interchangeable. However, the importance of these results for predicting patient outcome is yet to be elucidated. Nonetheless, these results were consistent in the inter and intraobserver analysis for post contrast T1 mapping, although native T1 mapping failed to show similar consistency. Figure 1: Bland-Altmann plot of differences (mean ± upper and lower limit of agreement-LOA) in scar area extent (percentage) between LGE and native T1 mapping (A), LGE and post contrast T1 mapping (B). The difference increases linearly for larger scar areas when using post contrast mapping, which does not apply for native mapping. Abstract Figure 1

Cine and late gadolinium enhancement MRI registration and automated myocardial infarct heterogeneity quantification.

To develop an approach for automated quantification of myocardial infarct heterogeneity in late gadolinium enhancement (LGE) cardiac MRI. We acquired 2D short-axis cine and 3D LGE in 10 pigs with myocardial infarct. The 2D cine myocardium was segmented and registered to the LGE images. LGE image signal intensities within the warped cine myocardium masks were analyzed to determine the thresholds of infarct core (IC) and gray zone (GZ) for the standard-deviation (SD) and full-width-at-halfmaximum (FWHM) methods. The initial IC, GZ, and IC + GZ segmentations were postprocessed using a normalized cut approach. Cine segmentation and cine-LGE registration accuracies were evaluated using dice similarity coefficient and average symmetric surface distance. Automated IC, GZ, and IC + GZ volumes were compared with manual results using Pearson correlation coefficient (r), Bland-Altman analyses, and intraclass correlation coefficient. For n = 87 slices containing scar, we achieved cine segmentation dice similarity coefficient = 0.87 ± 0.12, average symmetric surface distance = 0.94 ± 0.74 mm (epicardium), and 1.03 ± 0.82 mm (endocardium) in the scar region. For cine-LGE registration, dice similarity coefficient was 0.90 ± 0.06 and average symmetric surface distance was 0.72 ± 0.39 mm (epicardium) and 0.86 ± 0.53 mm (endocardium) in the scar region. For both SD and FWHM methods, automated IC, GZ, and IC + GZ volumes were strongly (r > 0.70) correlated with manual measurements, and the correlations were not significantly different from interobserver correlations (P > .05). The agreement between automated and manual scar volumes (intraclass correlation coefficient = 0.85-0.96) was similar to that between two observers (intraclass correlation coefficient = 0.81-0.99); automated scar segmentation errors were not significantly different from interobserver segmentation differences (P > .05). Our approach provides fully automated cine-LGE MRI registration and LGE myocardial infarct heterogeneity quantification in preclinical studies.

Improvement of late gadolinium enhancement image quality using a deep learning\u2013based reconstruction algorithm and its influence on myocardial scar quantification

ObjectivesThe aim of this study was to assess the effect of a deep learning (DL)–based reconstruction algorithm on late gadolinium enhancement (LGE) image quality and to evaluate its influence on scar quantification.MethodsSixty patients (46 ± 17 years, 50% male) with suspected or known cardiomyopathy underwent CMR. Short-axis LGE images were reconstructed using the conventional reconstruction and a DL network (DLRecon) with tunable noise reduction (NR) levels from 0 to 100%. Image quality of standard LGE images and DLRecon images with 75% NR was scored using a 5-point scale (poor to excellent). In 30 patients with LGE, scar size was quantified using thresholding techniques with different standard deviations (SD) above remote myocardium, and using full width at half maximum (FWHM) technique in images with varying NR levels.ResultsDLRecon images were of higher quality than standard LGE images (subjective quality score 3.3 ± 0.5 vs. 3.6 ± 0.7, p < 0.001). Scar size increased with increasing NR levels using the SD methods. With 100% NR level, scar size increased 36%, 87%, and 138% using 2SD, 4SD, and 6SD quantification method, respectively, compared to standard LGE images (all p values < 0.001). However, with the FWHM method, no differences in scar size were found (p = 0.06).ConclusionsLGE image quality improved significantly using a DL-based reconstruction algorithm. However, this algorithm has an important impact on scar quantification depending on which quantification technique is used. The FWHM method is preferred because of its independency of NR. Clinicians should be aware of this impact on scar quantification, as DL-based reconstruction algorithms are being used.Key Points• The image quality based on (subjective) visual assessment and image sharpness of late gadolinium enhancement images improved significantly using a deep learning–based reconstruction algorithm that aims to reconstruct high signal-to-noise images using a denoising technique.• Special care should be taken when scar size is quantified using thresholding techniques with different standard deviations above remote myocardium because of the large impact of these advanced image enhancement algorithms.• The full width at half maximum method is recommended to quantify scar size when deep learning algorithms based on noise reduction are used, as this method is the least sensitive to the level of noise and showed the best agreement with visual late gadolinium enhancement assessment.

Comparison of Segmentation Algorithms for Detecting Myocardial Infarction Using Late Gadolinium Enhancement Magnetic Resonance Imaging

Objective: The aim of this study was to validate the accuracy of a new automatic method for scar segmentation and compare its performance with that of two other frequently used segmentation algorithms. Methods: Twenty-six late gadolinium enhancement cardiovascular magnetic resonance images of diseased hearts were segmented by the full width at half maximum (FWHM) method, the n standard deviations (nSD) method, and our new automatic method. The results of the three methods were compared with the consensus ground truth obtained by manual segmentation of the ventricular boundaries. Results: Our automatic method yielded the highest Dice score and the lowest volume difference compared with the consensus ground truth segmentation. The nSD method produced large variations in the Dice score and the volume difference. The FWHM method yielded the lowest Dice score and the greatest volume difference compared with the automatic, 6SD, and 8SD methods, but resulted in less variation when different observers segmented the images. Conclusion: The automatic method introduced in this study is highly reproducible and objective. Because it requires no manual intervention, it may be useful for processing large datasets produced in clinical applications.

Comparison of histological and computed tomographic measurements of pig lung bronchi.

AimLight microscopy is used as template in the evaluation and further development of medical imaging methods. Tissue shrinkage caused by histological processing is known to influence lung tissue dimensions. In diagnosis of COPD, computed tomography (CT) is widely used for automated airway measurement. The aim of this study was to compare histological and computed tomographic measurements of pig lung bronchi.MethodsAirway measurements of pig lungs were performed after freezing under controlled inflation pressure in a liquid nitrogen bath. The wall thickness of seven bronchi was measured via Micro-CT and CT using the integral-based method (IBM) and the full-width-at-half-maximum method (FWHM) automatically and histologically on frozen and paraffin sections. Statistical analysis was performed using the Wilcoxon test, Pearson's correlation coefficient with a significance level at p<0.05, scatter plots and Bland–Altman plots.ResultsBronchial wall thickness was smallest in frozen sections (median 0.71 mm) followed by paraffin sections (median 0.75 mm), Micro-CT (median 0.84 mm), and CT measurements using IBM (median 0.68 mm) and FWHM (median 1.69 mm). Statistically significant differences were found among all tested groups (p<0.05) except for CT IBM and paraffin and frozen sections and Micro-CT. There was high correlation between all parameters with statistical significance (p<0.05).ConclusionsSignificant differences in airway measurement were found among the different methods. The absolute measurements with CT IBM were closest to the histological results followed by Micro-CT, whereas CT FWHM demonstrated a distinct divergence from the other groups.

Evaluation of estimated mesospheric temperatures from 11-year meteor radar datasets of King Sejong Station (62°S, 59°W) and Esrange (68°N, 21°E)

We have evaluated the reliability of two methods for estimating mesospheric temperatures from all-sky VHF meteor radar data. The first method utilizes the decay time of meteor trails, and the other method takes advantage of the linear relation between temperatures and the full width at half maximum (FWHM) of the observed meteor echoes height distribution. We estimated the temperatures from two meteor radar datasets of King Sejong Station (62.22°S, 58.78°W), Antarctic and Esrange, Sweden (67.90°N, 21.10°E) during a period of 2007–2017 and 2003 to 2013, respectively. We devised an improved decay time method of temperature estimation that utilizes careful selection of detected echoes by reflecting seasonal change in height range where ambipolar diffusion is dominant in meteor decay. Applying the improved method, we achieved temperature estimation on average within 6.2 and 5.4% from Aura/MLS temperatures around 90 km at Esrange and KSS, respectively. In comparison, temperatures estimated by the FWHM method have mean differences of 5.1 and 3.6% from the MLS temperatures at Esrange and KSS, respectively. The FWHM temperatures show significantly less discrepancy from MLS temperatures and temporal fluctuations than the temperatures estimated by the decay time for both sites. This may indicate that the FWHM method is more robust to estimate mesospheric temperatures from meteor radar data.

P595Characteristics of the right ventricle in patients with nonischemic dilated cardiomyopathy

Abstract Background In nonischemic dilated cardiomyopathy (DCM), diagnosis and prognosis is based on left ventricular function. Although concomitant right ventricular (RV) dysfunction is frequently observed, the underlying mechanism is currently not fully understood. Purpose We aimed to describe the characteristics of right ventricular function in DCM patients with cardiac magnetic resonance (CMR) imaging using cine and late-gadolinium enhancement (LGE) imaging. Methods Patients with DCM and left ventricular (LV) dysfunction (ejection fraction (EF) &lt;50%) on LGE-CMR were included prospectively. LV and RV volumes and function were quantified and RV systolic dysfunction was defined as RV ejection fraction (RVEF)&lt;45%. The presence and pattern of LGE were assessed visually and the extent was quantified using the full-width half maximum method. Septal midmyocardial LGE pattern was defined as midwall striae or hinge-point myocardial hyperenhancement. Moreover, left atrial (LA) volumes were calculated using the bi-plane area-length method. Results The study included 214 DCM patients (42% female, age 58±14 years) with a mean LVEF of 34±12% and RVEF of 46±12%. RV systolic dysfunction was present in 39% and was associated with the presence of septal midwall LGE (OR 1.96 (95% CI 1.09–3.54) p=0.026). In patients with RV dysfunction, LV dilation was more severe (LV end diastolic volume (EDV) 242±97mL vs. 212±58mL, p=0.011) and LVEF was lowere (26±12% vs. 39±8%, p&lt;0.001) (figure A). There was a weak correlation between septal LGE amount and LVEDV and RVEDV (respectively r=0.36, p=0.003 and r=0.35, p=0.005) In patients with RV dysfunction, left atrial volumes were enlarged (56±23mL/m2 vs. 46±14mL/m2, p&lt;0.001) and LA emptying fraction was moderately correlated to RVEF (figure B), also after exclusion of patients with a history of atrial fibrillation. RVEF in DCM patients Conclusion In DCM, reduced RVEF predominantly occurred in patients with a) LVEF lower than 30%, b) septal midwall enhancement, indicating progressive LV remodeling, c) LA dilation and d) LA dysfunction. This suggests that RV dysfunction in advanced DCM is drive by LV diastolic dysfunction resulting in increased afterload of the RV.

A full-width half-maximum method to assess retinal vascular structural changes in patients with ischemic heart disease and microvascular angina

Chest pain patients without obstructive ischemic heart disease (IHD) have increased attention in the clinical practice as carrying higher cardiovascular (CV) risk and impaired life quality. Retinal vasculature is a novel but reliable risk factor of atherosclerosis and systemic vascular diseases. However, the association of retinal blood vessels and unobstructed IHD, as known as microvascular angina (MA) is poorly understood. This study compared retinal vascular structures of obstructive IHD and MA using spectral domain optical coherence tomography (SD-OCT) and full-width half-maximum (FWHM) methods to provide new risk predictive evidence of MA. Fundus vessels of 120 IHD patients, including 91epicardial IHD and 29 MA patients, and 66 control subjects were evaluated. Significant differences in the retinal arterial lumen diameter (RALD), retinal arterial outer diameter (RAOD), and arteriovenous ratio (AVR) have been found (P < 0.05). The severity of IHD was negatively correlated with diameters of RAOD, RALD and AVR (P < 0.05). In conclusion, there were significant differences in the retinal vascular structure between IHD patients and patients with MA. Thus, assessment of retinal vascular structure is suggested to evaluate CV risk of IHD patients, despite having no obstructive IHD.

An integrated method based on energy concentration for evaluating normally distributed spectra in the visible region

This work proposes a method to scientifically quantify the quality of normally distributed visible spectra from the viewpoint of energy concentration: high transmittance, narrow spectral width, and small deviation from the target wavelength in the target region. In the proposed method, the spectral width of the spectrum is compared with that of a reference spectrum before its deviation from the target wavelength is examined. After extracting the maximum transmittance, a performance index of the spectrum is obtained in a percentile value. The effectiveness of the proposed method was analytically proven by surface plasmon resonance-generated spectra with five design features and five variations in each feature. The results indicated that the proposed method not only substantially reflected the predictions made by intuitive visual inspections, but also avoided misleading and ambiguous results evaluated by existing full-width-at-half-maximum (FWHM) method, figure-of-merit (FOM) method, and coordinates on the chromaticity diagram. In addition to the numerical analysis, the experimentally obtained spectra of phosphors in white light emitting diodes were also evaluated. The results proved that the proposed method can successfully highlight the scaled performance difference among the spectra, which is not supported by existing FWHM and FOM methods by simultaneously considering the aforementioned three characteristics of a spectrum.

Comparison of semi-automated quantification methods of late gadolinium enhancement with cardiac magnetic resonance imaging in patients with hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy (HCM) is one of the first causes of sudden cardiac death (SCD) in young patients. The presence of late gadolinium enhancement (LGE) in cardiac magnetic resonance (CMR) imaging is a marker of myocardial fibrosis. Extent of LGE has been shown to be associated with the risk of SCD among other markers. There is no consensus regarding the method of quantification of LGE. The purpose of this study was to identify the most reliable and reproducible semi-automatic method of LGE quantification to predict SCD risk. In total, 103 patients from the center of hereditary cardiac diseases were prospectively included. Fifty-three patients with LGE underwent different semi-automated quantification methods for LGE evaluation: nSD-Standard Deviation (from 2 to 6SD) and FWHM (full width at half maximum) with a direct comparison with reference method using manual tracing. Inter- and intra- Observer reproducibility has been assessed. FWHM and 5SD methods were the closest to the manual technique (respectively 10,8 ± 7,5% and 9,3 ± 7,4% versus 10,3 ± 8,1% for manual tracing, P < 0,01). 2SD, 3SD and 4SD overestimated the results, whereas 6SD technique underestimated the results compared to the manual method. Intra and inter- reproducibility were fine with a better results using FWHM method. 5SD and especially FWHM methods were the most reliable and reproducible for the LGE semi-automated quantification in CMR for patients with HCM.

A universal parameterized gradient-based method for photon beam field size determination.

To propose a universal, parameterized gradient-based method (PGM) for radiation field size determination. The PGM locates the beam profile's edge by parameterizing its penumbra region with a modified sigmoid function where the inflection point can be determined in a closed form. The parametrization was validated with filter-flattened (FF), flattening-filter-free (FFF) and wedged profiles measured on two Elekta linac models (Synergy and Versa HD). Gamma analysis with the delta dose function set to zero was used to quantitatively assess the parameterization accuracy. Field sizes of FF beams were calculated with the PGM and the full width at half maximum (FWHM) methods for comparison. To assess the consistency of the PGM and the FWHM method with geometric scaling across different depths, the calculated field size at a reference depth was scaled to other depths and compared with the field sizes calculated from the measured profiles. The method was also validated against a maximum-slope method (MSM) with wedge and FFF profiles. We also evaluated the robustness of the three methods with respect to measurement noise, varying scanning step sizes, detector characteristics, and beam energy/modality. Small distance-to-agreement (0.02±0.02mm) between the measured and parameterized penumbra region was observed for all profiles. The differences between the field sizes calculated with the FWHM method and the PGM were consistent (0.9±0.3mm), with the FWHM method yielding larger values. With geometrical scaling, the PGM and the FWHM method produced maximum differences of 0.26 and 1.16mm, respectively. For wedge and FFF beams, the mean differences relative to FF fields were 0.15±0.09mm and 0.57±0.91mm for the PGM and the MSM, respectively. The PGM was also found to produce more consistent results than the FWHM method and the MSM when measurement noise, scanning step size, detector characteristics, and beam energy/modality changed. The proposed PGM is universally applicable to all beam modalities (FF, wedge and FFF) for accurate field size determination. Compared to the FWHM and the MSM, it is more robust to variations in measurement condition and detection system.

Impact of advanced modeled iterative reconstruction on interreader agreement in coronary artery measurements

ObjectivesTo evaluate the influence of advanced modeled iterative reconstruction (ADMIRE) on coronary artery computed tomography angiography (cCTA) measurements in comparison to filtered back projection (FBP). Material and methodsPhantom scans and coronary CTA studies of 27 patients were acquired with a third generation dual-source CT scanner. Images were reconstructed using FBP and ADMIRE. Phantom measurements were used as reference standard. In patient studies, representative axial slices of each coronary artery segment without (n=308) and with coronary plaques (n=40) were assessed in identical positions for comparison of FBP and ADMIRE reconstructions. Image analyses included quality assessment, phantom and coronary artery measurements, plaque analysis, and interreader agreement of two independent and blinded readers. ResultsMean image noise was lower on ADMIRE reconstructions with 31.3±9.9 HU compared to 55.9±15.7 HU on FBP reconstructions (p<0.001). Measurement precision and interreader agreement of both observers were assessed satisfactorily on phantom images in comparison to the full width half maximum method. In patients, correlation of lumen diameters of both observers improved using ADMIRE with a Pearson’s r=0.987 (95% confidence interval [CI], 0.983–0.989; p<0.001) compared to FBP images with r=0.939 (95% CI, 0.924–0.951; p<0.001). Applying ADMIRE, agreement of both observers for lumen diameter measurements significantly increased (p<0.001). This was also observed for the degree of stenosis (p<0.001) with r=0.560 using FBP (95% CI, 0.301–0.742) and with r=0.818 using ADMIRE (95% CI, 0.680–0.900). Plaque density measurements correlated closely with a Pearson’s r of 0.951 in FBP (95% CI, 0.909–0.974) and 0.967 in ADMIRE (95% CI, 0.939–0.983). ConclusionsAdvanced modeled iterative reconstruction significantly improves coronary artery assessment in coronary CTA in comparison to FBP by improved image quality due to image noise removal. This renders improved interobserver agreement for coronary lumen diameter and degree of stenosis measurements without influencing mean plaque attenuation.

Age-independent myocardial infarct quantification by signal intensity percent infarct mapping in swine.

To test whether signal intensity percent infarct mapping (SI-PIM) accurately determines the size of myocardial infarct (MI) regardless of infarct age. Forty-five swine with reperfused MI underwent 1.5T late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) after bolus injection of 0.2 mmol/kg Gd(DTPA) on days 2-62 following MI. Animals were classified into acute, healing, and healed groups by pathology. Infarct volume (IV) and infarct fraction (IF) were determined by two readers, using binary techniques (including 2-5 standard deviations [SD] above the remote, and full-width at half-maximum) and the SI-PIM method. Triphenyl-tetrazolium-chloride staining (TTC) was performed as reference. Bias (percent under/overestimation of IV relative to TTC) of each quantification method was calculated. Bland-Altman analysis was done to test the accuracy of the quantification methods, while intraclass correlation coefficient (ICC) analysis was done to assess intra- and interobserver agreement. Bias of the MRI quantification methods do not depend on the age of the MI. Full-width at half-maximum (FWHM) and SI-PIM gave the best estimate of MI volume determined by the reference TTC (P-values for the FWHM and SI-PIM methods were 0.183, 0.26, 0.95, and 0.073, 0.091, 0.73 in Group 1, Group 2, and Group 3, respectively), while using any of the binary thresholds of 2-4 SDs above the remote myocardium showed significant overestimation. The 5 SD method, however, provided similar IV compared to TTC and was shown to be independent of the size and age of MI. ICC analysis showed excellent inter- and intraobserver agreement between the readers. Our results indicate that the SI-PIM method can accurately determine MI volume regardless of the pathological stage of MI. Once tested, it may prove to be useful for the clinic.