title: Highly automatic quantification of myocardial oedema in patients with acute myocardial infarction using bright blood T2-weighted CMR.
abstract: BACKGROUND
  T2-weighted cardiovascular magnetic resonance (CMR) is clinically-useful for imaging the ischemic area-at-risk and amount of salvageable myocardium in patients with acute myocardial infarction (MI). However, to date, quantification of oedema is user-defined and potentially subjective.
  
  
  METHODS
  We describe a highly automatic framework for quantifying myocardial oedema from bright blood T2-weighted CMR in patients with acute MI. Our approach retains user input (i.e. clinical judgment) to confirm the presence of oedema on an image which is then subjected to an automatic analysis. The new method was tested on 25 consecutive acute MI patients who had a CMR within 48 hours of hospital admission. Left ventricular wall boundaries were delineated automatically by variational level set methods followed by automatic detection of myocardial oedema by fitting a Rayleigh-Gaussian mixture statistical model. These data were compared with results from manual segmentation of the left ventricular wall and oedema, the current standard approach.
  
  
  RESULTS
  The mean perpendicular distances between automatically detected left ventricular boundaries and corresponding manual delineated boundaries were in the range of 1-2 mm. Dice similarity coefficients for agreement (0=no agreement, 1=perfect agreement) between manual delineation and automatic segmentation of the left ventricular wall boundaries and oedema regions were 0.86 and 0.74, respectively.
  
  
  CONCLUSIONS
  Compared to standard manual approaches, the new highly automatic method for estimating myocardial oedema is accurate and straightforward. It has potential as a generic software tool for physicians to use in clinical practice.
authors.affiliation: University of Glasgow, Glasgow, G12 8TA, UK.
authors.forename: Hao
authors.initials: H
authors.lastname: Gao
authors.forename: Kushsairy
authors.initials: K
authors.lastname: Kadir
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Payne
authors.forename: John
authors.initials: J
authors.lastname: Soraghan
authors.forename: Colin
authors.initials: C
authors.lastname: Berry
mesh_terms: D000328:Adult; D000368:Aged; D001331:Automation; D004489:Edema, Cardiac / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000473:pathology; D009206:Myocardium / Q000473:pathology*; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012984:Software
references.citation: J Magn Reson Imaging. 2003 Oct;18(4):434-41
references.pmid: 14508780
references.citation: Med Image Anal. 2004 Sep;8(3):255-65
references.pmid: 15450220
references.citation: Magn Reson Med. 2011 Aug;66(2):564-73
references.pmid: 21394767
references.citation: JACC Cardiovasc Imaging. 2009 May;2(5):569-76
references.pmid: 19442942
references.citation: Circ Cardiovasc Imaging. 2010 Sep;3(5):527-35
references.pmid: 20631034
references.citation: Med Image Anal. 2011 Apr;15(2):169-84
references.pmid: 21216179
references.citation: Magn Reson Med. 1995 Dec;34(6):910-4
references.pmid: 8598820
references.citation: Cardiovasc Res. 1993 Aug;27(8):1462-9
references.pmid: 8297415
references.citation: Radiology. 2001 Jan;218(1):215-23
references.pmid: 11152805
references.citation: Circulation. 2004 May 25;109(20):2411-6
references.pmid: 15123531
references.citation: Invest Radiol. 2008 Jan;43(1):7-15
references.pmid: 18097272
references.citation: J Cardiovasc Magn Reson. 2012 Jan 31;14:10
references.pmid: 22293146
references.citation: Circ Cardiovasc Imaging. 2011 Nov;4(6):738-45
references.pmid: 21930836
references.citation: Circ Cardiovasc Imaging. 2011 May;4(3):210-9
references.pmid: 21427362
references.citation: Magn Reson Med. 2008 Feb;59(2):229-35
references.pmid: 18228588
references.citation: J Magn Reson Imaging. 2013 Feb;37(2):382-90
references.pmid: 23011840
references.citation: JACC Cardiovasc Imaging. 2012 Jun;5(6):596-603
references.pmid: 22698528
references.citation: Am J Physiol. 1998 Mar;274(3):H937-44
references.pmid: 9530207
references.citation: IEEE Trans Med Imaging. 1994;13(4):716-24
references.pmid: 18218550
references.citation: Circulation. 2006 Apr 18;113(15):1821-3
references.pmid: 16618830
references.citation: J Am Coll Cardiol. 2000 Nov 15;36(6):1985-91
references.pmid: 11092675
references.citation: Magn Reson Med. 2002 Feb;47(2):372-83
references.pmid: 11810682
references.citation: IEEE Trans Med Imaging. 2003 Jun;22(6):773-6
references.pmid: 12872953
references.citation: Circulation. 2006 Apr 18;113(15):1865-70
references.pmid: 16606793
references.citation: Phys Med Biol. 2012 Oct 7;57(19):6007-23
references.pmid: 22968138
references.citation: J Magn Reson Imaging. 2006 Mar;23(3):298-308
references.pmid: 16450367