title: Quantification of left ventricular volume and global function using a fast automated segmentation tool: validation in a clinical setting.
abstract: Real-time 3D echocardiography (RT3DE) has already been shown to be an accurate tool for left ventricular (LV) volume assessment. However, LV border detection in RT3DE remains a time-consuming task jeopardizing the application of this modality in routine practice. We have recently developed a 3D automated segmentation framework (BEAS) able to capture the LV morphology in real-time. The goal of this study was to assess the accuracy of this approach in extracting volumetric parameters in a clinical setting. 24 RT3DE exams were acquired in a group of healthy volunteers (# = 5) and diseased patients (# = 19), with LV volume/function within a range typically measured in a clinical setting. End-diastolic and end-systolic volumes (EDV, ESV) were manually contoured by 3 expert sonographers from which the stroke volume and ejection fraction (SV, EF) were calculated. The values extracted with BEAS were compared to the average of the 3 experts measurements using correlation and Bland-Altman statistics. Linear regression analysis showed a strong correlation between the automated algorithm and the reference values (R = 0.963, 0.947, 0.944 and 0.853 for EDV, ESV, SV and EF respectively). Bland-Altman analysis revealed a bias (limits of agreement) of 2.59 (-25.39, 30.57) ml, -2.11 (-24.91, 20.69) ml, 4.70 (12.93, 22.34) ml and 3.45 (-8.96, 15.87) %, for EDV, ESV, SV and EF respectively. Total analysis time using BEAS was 30.7 ± 7.5 s. BEAS allows for a fast and accurate quantification of 3D cardiac volumes and global function with minimal user input. It may therefore contribute to the integration of 3D echocardiography in routine clinical practice.
authors.affiliation: Laboratory on Cardiovascular Imaging & Dynamics, Department of Cardiovascular Sciences, KU Leuven, Herestraat 49, bus 7003, 3000, Leuven, Belgium. daniel.barbosa@uzleuven.be
authors.forename: Daniel
authors.initials: D
authors.lastname: Barbosa
authors.forename: Brecht
authors.initials: B
authors.lastname: Heyde
authors.forename: Thomas
authors.initials: T
authors.lastname: Dietenbeck
authors.forename: Helene
authors.initials: H
authors.lastname: Houle
authors.forename: Denis
authors.initials: D
authors.lastname: Friboulet
authors.forename: Olivier
authors.initials: O
authors.lastname: Bernard
authors.forename: Jan
authors.initials: J
authors.lastname: D'hooge
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001331:Automation; D002648:Child; D019560:Echocardiography, Three-Dimensional; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016277:Ventricular Function, Left; D055815:Young Adult