title: High-resolution transthoracic real-time three-dimensional echocardiography: quantitation of cardiac volumes and function using semi-automatic border detection and comparison with cardiac magnetic resonance imaging.
abstract: OBJECTIVE
  We sought to validate high-resolution transthoracic real-time (RT) three-dimensional echocardiography (3DE), in combination with a novel semi-automatic contour detection algorithm, for the assessment of left ventricular (LV) volumes and function in patients.
  
  
  BACKGROUND
  Quantitative RT-3DE has been limited by impaired image quality and time-consuming manual data analysis.
  
  
  METHODS
  Twenty-four subjects with abnormal (n = 14) or normal (n = 10) LVs were investigated. The results for end-diastolic volume (EDV), end-systolic volume (ESV), and ejection fraction (EF) obtained by manual tracing were compared with the results determined by the semi-automatic border detection algorithm. Moreover, the results of the semi-automatic method were compared with volumes and EF obtained by cardiac magnetic resonance imaging (CMRI).
  
  
  RESULTS
  Excellent correlation coefficients (r = 0.98 to 0.99) and low variability (EDV -1.3 +/- 8.6 ml; ESV -0.2 +/- 5.4 ml; EF -0.1 +/- 2.7%; p = NS) were observed between the semi-automatically and manually assessed data. The RT-3DE data correlated highly with CMRI (r = 0.98). However, LV volumes were underestimated by RT-3DE compared with CMRI (EDV -13.6 +/- 18.9 ml, p = 0.002; ESV -12.8 +/- 20.5 ml, p = 0.005). The difference for EF was not significant between the two methods (EF 0.9 +/- 4.4%, p = NS). Observer variability was acceptable, and repeatability of the method was excellent.
  
  
  CONCLUSIONS
  The RT-3DE, in combination with a semi-automatic contour tracing algorithm, allows accurate determination of cardiac volumes and function compared with both manual tracing and CMRI. High repeatability suggests applicability of the method for the serial follow-up of patients with cardiac disease.
authors.affiliation: Medizinische Klinik I, Aachen, Germany. hkuehl@ukaachen.de
authors.forename: Harald P
authors.initials: HP
authors.lastname: Kühl
authors.forename: Marcus
authors.initials: M
authors.lastname: Schreckenberg
authors.forename: Dierk
authors.initials: D
authors.lastname: Rulands
authors.forename: Markus
authors.initials: M
authors.lastname: Katoh
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schäfer
authors.forename: Georg
authors.initials: G
authors.lastname: Schummers
authors.forename: Arno
authors.initials: A
authors.lastname: Bücker
authors.forename: Peter
authors.initials: P
authors.lastname: Hanrath
authors.forename: Andreas
authors.initials: A
authors.lastname: Franke
mesh_terms: D000368:Aged; D000465:Algorithms; D016022:Case-Control Studies; D019560:Echocardiography, Three-Dimensional / Q000592:standards*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000473:pathology; D016277:Ventricular Function, Left / Q000502:physiology*