title: Accuracy of automated attenuation-based 3-dimensional segmentation: in the analysis of left ventricular function compared with magnetic resonance imaging.
abstract: We evaluated attenuation-based 3-dimensional segmentation for the analysis of left ventricular function, using as our standard of reference magnetic resonance imaging and dual-source computed tomography with traditional short-axis planimetry.Twenty patients with known or suspected coronary artery disease were examined prospectively. In all magnetic resonance and computed tomographic datasets, global functional values were determined by 2-dimensional planimetry. Computed tomographic scans were further evaluated by automated 3-dimensional segmentation, and the results were compared by Pearson correlation and Bland-Altman analysis.Agreement between magnetic resonance imaging and dual-source computed tomographic 2-dimensional planimetry was good for all values (end-diastolic volume, bias= -4.2, r=0.99; end-systolic volume, bias= -1.7, r=0.99, stroke-volume, bias= -2.4, r=0.98; ejection fraction, bias=0.26, r=0.94; and myocardial mass, bias= 2.5, r=0.90). By contrast, dual-source computed tomographic 3-dimensional segmentation overestimated end-diastolic volume (bias= -19.1, P <0.001), stroke-volume (bias= -16.9, P <0.001), and myocardial mass (bias= -34.4, P <0.001). Moreover, correlation with magnetic resonance imaging proved disappointing for ejection fraction (r=0.72). Results were similar in a direct comparison between dual-source computed tomographic 2-dimensional planimetry and 3-dimensional segmentation (end-diastolic volume, bias= -14.9, r=0.94; end-systolic volume, bias= -0.5, r=0.90; stroke volume, bias= -14.5, r=0.83; ejection fraction, bias= -2.8, r=0.74; and myocardial mass, bias= -36.8, r=0.79).Due to significant overestimation of volumes and poor correlation of ejection fraction with cine magnetic resonance imaging results, attenuation-based 3-dimensional segmentation compares unfavorably with traditional planimetry. Hence this method should be used with caution, and its time benefits should be weighed against its imprecision of functional analysis.
authors.affiliation: Department of Diagnostic Radiology, Division of Sports Medicine, Eberhard-Karls-University, 72076 Tübingen, Germany. h.brodoefel@t-online.de
authors.forename: Harald
authors.initials: H
authors.lastname: Brodoefel
authors.forename: Ilias
authors.initials: I
authors.lastname: Tsiflikas
authors.forename: Ulrich
authors.initials: U
authors.lastname: Kramer
authors.forename: Nina
authors.initials: N
authors.lastname: Lang
authors.forename: Anja
authors.initials: A
authors.lastname: Reimann
authors.forename: Christoph
authors.initials: C
authors.lastname: Burgstahler
authors.forename: Claus D
authors.initials: CD
authors.lastname: Claussen
authors.forename: Martin
authors.initials: M
authors.lastname: Heuschmid
mesh_terms: D000368:Aged; D057205:Automation, Laboratory; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D005858:Germany; D006801:Humans; D021621:Imaging, Three-Dimensional; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D013318:Stroke Volume; D014057:Tomography, X-Ray Computed; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D016277:Ventricular Function, Left