title: Evaluation of quantification methods for left arial late gadolinium enhancement based on different references in patients with atrial fibrillation.
abstract: By using late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) imaging, we compared left atrial late gadolinium enhancement (LA-LGE) quantification methods based on different references to characterize the left atrial wall in patients with atrial fibrillation (AF). Thirty-eight patients who underwent three-dimensional LGE-CMR imaging before catheter ablation for AF were classified into three groups depending on their clinical AF type: (1) paroxysmal AF (PAF; n = 12); (2) persistent AF (PeAF; n = 16); and (3) recurrent AF after catheter ablation (RAF; n = 10). To quantify LA-LGE on LGE-CMR imaging, we used the thresholds of 2 standard deviations (2-SD), 3-SD, 4-SD, 5-SD, or 6-SD above the mean signal from the unenhanced left ventricular myocardium, and we used the full width at half maximum (FWHM) technique, which was based on the maximum signal from the mitral valve with high signal intensity. The 6-SD threshold and FWHM techniques were statistically reproducible with an intraclass correlation coefficient >0.7. On applying the FWHM technique, the normalized LA-LGE volume by LA wall area showed a significant difference between the RAF, PeAF, and PAF groups (0.22 ± 0.04, 0.16 ± 0.06, and 0.09 ± 0.03 mL/cm(2), respectively) (P < 0.05). Furthermore, most of the fibrotic scarring and low-voltage tissue on the electroanatomic map corresponded well with the extent of LA-LGE. The FWHM technique based on the mitral valve can provide a reproducible quantification of LA-LGE related to AF in the thin LA wall.
authors.affiliation: Department of Radiology, Korea University Medical Center, Seoul, Republic of Korea.
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Hwang
authors.forename: Yu-Whan
authors.initials: YW
authors.lastname: Oh
authors.forename: Dae In
authors.initials: DI
authors.lastname: Lee
authors.forename: Jaemin
authors.initials: J
authors.lastname: Shim
authors.forename: Sang-Weon
authors.initials: SW
authors.lastname: Park
authors.forename: Young-Hoon
authors.initials: YH
authors.lastname: Kim
mesh_terms: D000368:Aged; D000465:Algorithms; D001281:Atrial Fibrillation / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D016279:Atrial Function, Left; D017115:Catheter Ablation; D003287:Contrast Media; D022062:Electrophysiologic Techniques, Cardiac; D005240:Feasibility Studies; D005260:Female; D005355:Fibrosis; D006325:Heart Atria / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008536:Meglumine; D008875:Middle Aged; D009942:Organometallic Compounds; D011237:Predictive Value of Tests; D015203:Reproducibility of Results
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D008536:Meglumine; C072417:gadoterate meglumine