title: Comparison of various methods for quantitative evaluation of myocardial infarct volume from magnetic resonance delayed enhancement data.
abstract: BACKGROUND
  Late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) enables the estimation of myocardial infarct (MI) extent. Nevertheless, manual quantification is time consuming and subjective. We sought to assess MI volume with different quantitative methods in both acute (AMI) and chronic MI (CMI).
  
  
  METHODS
  CMR was performed 50 ± 21 h after MI in 52 patients and was repeated 100 ± 21 days later in a subgroup of 34 patients. Then, necrosis volumes were quantified using: 1) manual delineation, 2) automated fuzzy c-means method, and 3) +2 to 6 SD thresholding approaches. Results were compared against peak values of serum Troponin I (TnI), creatine kinase (CK) and left ventricular (LV) functional parameters: LV ejection fraction (LVEF), indexed end-diastolic (EDVi), end-systolic volumes (ESVi) and the number of hypokinetic segments (NbHk).
  
  
  RESULTS
  For CMI, quantitative evaluation of infarct size using manual, +2SD, +3 SD and fuzzy c-means provided equivalent results in terms of correlation coefficients for comparisons of MI volumes against LV function parameters (LVEF: r>0.79, p<0.0001; ESVi: r>0.82, p<0.0001, EDVi: r>0.67, p<0.0001, NbHk: r>0.54, p<0.0009). For AMI, +2SD and fuzzy c-means approaches provided higher correlations for comparisons of AMI volumes against biochemical markers (CK: r>0.79, p<0.0001,TnI: r>0.77, p<0.0001) and chronic LV function parameters (LVEF: r>0.82, p<0.0001, NbHk: r>0.59, p<0.0002).
  
  
  CONCLUSIONS
  The fuzzy c-means and 2SD methods provided highest correlations with biochemical MI quantification as well as LV function parameters. The fuzzy c-means approach which does not require an arbitrary identification of the remote myocardium is fast and reproducible. It may be clinically useful in the evaluation of patients with MI.
authors.affiliation: Cardiology Department, and INSERM U937, Pitie-Salpetriere Medical Center, Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Baron
authors.forename: N
authors.initials: N
authors.lastname: Kachenoura
authors.forename: P
authors.initials: P
authors.lastname: Cluzel
authors.forename: F
authors.initials: F
authors.lastname: Frouin
authors.forename: A
authors.initials: A
authors.lastname: Herment
authors.forename: P
authors.initials: P
authors.lastname: Grenier
authors.forename: G
authors.initials: G
authors.lastname: Montalescot
authors.forename: F
authors.initials: F
authors.lastname: Beygui
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000592:standards*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology; D011446:Prospective Studies; D013223:Statistics as Topic / Q000592:standards*