title: Role of sonographic automatic volume calculation in measuring fetal cardiac ventricular volumes using 4-dimensional sonography: comparison with virtual organ computer-aided analysis.
abstract: OBJECTIVE
  The purpose of this study was to compare the agreement and reliability of virtual organ computer-aided analysis (VOCAL) and sonographic automatic volume calculation (sonoAVC) for measurements of ventricular volume from fetal heart data sets acquired by 4-dimensional sonography with spatiotemporal image correlation (STIC).
  
  
  METHODS
  We studied 45 volumes from fetuses with normal (n = 30) and abnormal (n = 15) hearts. Spatiotemporal image correlation data sets were frozen in end systole and end diastole, and ventricular volumes were measured with VOCAL and sonoAVC. The stroke volume was calculated from these measurements. Reliability and agreement of the two techniques were evaluated with intraclass correlation coefficients (ICCs), and proportionate Bland-Altman plots were constructed. The time necessary to complete the measurements with either technique was compared. Intraobserver and interobserver agreement of measurements was calculated.
  
  
  RESULTS
  All data sets could be measured with both techniques. A high degree of reliability was observed between VOCAL and sonoAVC (left ventricular stroke volume ICC, 0.978; 95% confidence interval [CI], 0.957-0.989; right ventricular stroke volume ICC, 0.985; 95% CI, 0.972-0.992). The time necessary to measure the stroke volume was significantly shorter with sonoAVC (2.8 versus 11.7 minutes; P < .0001) than with VOCAL. Bland-Altman tests showed no clinically significant mean percent differences between stroke volume measurements obtained from each ventricle by the same observer or by 2 independent observers using either VOCAL or sonoAVC.
  
  
  CONCLUSIONS
  There was good agreement between cardiac volumes measured with VOCAL and sonoAVC. Sonographic automatic volume calculation represents a rapid technique for estimating fetal stroke volume and promises to become the method of choice.
authors.affiliation: Department of Obstetrics and Gynecology, University of Rome Tor Vergata, Fatebenefratelli S. Giovanni Calabita Hospital, Isola Tiberina 89, 00186 Rome, Italy. giuseppe.rizzo@uniroma2.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rizzo
authors.forename: Alessandra
authors.initials: A
authors.lastname: Capponi
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Pietrolucci
authors.forename: Domenico
authors.initials: D
authors.lastname: Arduini
mesh_terms: D000465:Algorithms; D055424:Cardiac-Gated Imaging Techniques / Q000379:methods*; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D009929:Organ Size; D011247:Pregnancy; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal / Q000379:methods*