title: Unsupervised fully automated inline analysis of global left ventricular function in CINE MR imaging.
abstract: OBJECTIVE
  To implement and evaluate the accuracy of unsupervised fully automated inline analysis of global ventricular function and myocardial mass (MM). To compare automated with manual segmentation in patients with cardiac disorders.
  
  
  METHODS
  In 50 patients, cine imaging of the left ventricle was performed with an accelerated retrogated steady state free precession sequence (GRAPPA; R = 2) on a 1.5 Tesla whole body scanner (MAGNETOM Avanto, Siemens Healthcare, Germany). A spatial resolution of 1.4 x 1.9 mm was achieved with a slice thickness of 8 mm and a temporal resolution of 42 milliseconds. Ventricular coverage was based on 9 to 12 short axis slices extending from the annulus of the mitral valve to the apex with 2 mm gaps. Fully automated segmentation and contouring was performed instantaneously after image acquisition. In addition to automated processing, cine data sets were also manually segmented using a semi-automated postprocessing software. Results of both methods were compared with regard to end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF), and MM. A subgroup analysis was performed in patients with normal (> or =55%) and reduced EF (<55%) based on the results of the manual analysis.
  
  
  RESULTS
  Thirty-two percent of patients had a reduced left ventricular EF of <55%. Volumetric results of the automated inline analysis for EDV (r = 0.96), ESV (r = 0.95), EF (r = 0.89), and MM (r = 0.96) showed high correlation with the results of manual segmentation (all P < 0.001). Head-to-head comparison did not show significant differences between automated and manual evaluation for EDV (153.6 +/- 52.7 mL vs. 149.1 +/- 48.3 mL; P = 0.05), ESV (61.6 +/- 31.0 mL vs. 64.1 +/- 31.7 mL; P = 0.08), and EF (58.0 +/- 11.6% vs. 58.6 +/- 11.6%; P = 0.5). However, differences were significant for MM (150.0 +/- 61.3 g vs. 142.4 +/- 59.0 g; P < 0.01). The standard error was 15.6 (EDV), 9.7 (ESV), 5.0 (EF), and 17.1 (mass). The mean time for manual analysis was 15 minutes.
  
  
  CONCLUSIONS
  Unsupervised fully automated segmentation and contouring during image reconstruction enables an accurate evaluation of global systolic cardiac function.
authors: Department of Clinical Radiology, University Hospitals of Munich Grosshadern, Munich, Germany. daniel.theisen@med.uni-muenchen.de
authors: Daniel
authors: D
authors: Theisen
authors: Torleif A
authors: TA
authors: Sandner
authors: Kerstin
authors: K
authors: Bauner
authors: Carmel
authors: C
authors: Hayes
authors: Carsten
authors: C
authors: Rist
authors: Maximilian F
authors: MF
authors: Reiser
authors: Bernd J
authors: BJ
authors: Wintersperger
mesh_terms: D000465:Algorithms; D001185:Artificial Intelligence; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D009862:Online Systems; D010363:Pattern Recognition, Automated / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis*; D051598:Whole Body Imaging / Q000379:methods*