title: A Practical Algorithm for Improving Localization and Quantification of Left Ventricular Scar.
abstract: Current approaches to classification of left ventricular scar rely on manual segmentation of myocardial borders and manual classification of scar tissue. In this paper, we propose an novel, semi-automatic approach to segment the left ventricular wall and classify scar tissue using a combination of modern image processing techniques. We obtained high-resolution magnetic resonance angiograms (MRA) and late-gadolinium enhanced magnetic resonance imaging (LGE-MRI) in 14 patients who had ventricular scar from a prior myocardial infarction. We applied (1) a level set-based segmentation approach using a combination of the MRA and LGE-MRI to segment the myocardium and then (2) an automated signal intensity algorithm (Otsu thresholding) to identify ventricular scar tissue. We compared results from both steps to those of expert observers. The LVgeometry using the semi-automated segmentation method had a mean overlap of 94% with the manual segmentations. The scar volumes obtained with the Otsu method correlated with the expert observer scar volumes (Dice comparison coefficient of 0.85± 0.11). This proof of concept segmentation pipeline provides a more objective method for identifying scar in the left ventricle than manual approaches.
authors.affiliation: Comprehensive Arrhythmia Research and Management Center, Salt Lake City, United States ; Department of Bioengineering, University of Utah, Salt Lake City, United States.
authors.forename: Brian
authors.initials: B
authors.lastname: Zenger
authors.affiliation: Comprehensive Arrhythmia Research and Management Center, Salt Lake City, United States ; Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, United States.
authors.forename: Joshua
authors.initials: J
authors.lastname: Cates
authors.affiliation: Comprehensive Arrhythmia Research and Management Center, Salt Lake City, United States.
authors.forename: Alan
authors.initials: A
authors.lastname: Morris
authors.affiliation: Comprehensive Arrhythmia Research and Management Center, Salt Lake City, United States ; Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, UT, United States.
authors.forename: Eugene
authors.initials: E
authors.lastname: Kholmovski
authors.affiliation: Comprehensive Arrhythmia Research and Management Center, Salt Lake City, United States.
authors.forename: Alexander
authors.initials: A
authors.lastname: Au
authors.affiliation: Comprehensive Arrhythmia Research and Management Center, Salt Lake City, United States ; University of Utah School of Medicine, University of Utah, Salt Lake City, UT, United States.
authors.forename: Ravi
authors.initials: R
authors.lastname: Ranjan
authors.affiliation: Comprehensive Arrhythmia Research and Management Center, Salt Lake City, United States ; University of Utah School of Medicine, University of Utah, Salt Lake City, UT, United States.
authors.forename: Nazem
authors.initials: N
authors.lastname: Akoum
authors.affiliation: Comprehensive Arrhythmia Research and Management Center, Salt Lake City, United States ; University of Utah School of Medicine, University of Utah, Salt Lake City, UT, United States.
authors.forename: Chris
authors.initials: C
authors.lastname: McGann
authors.affiliation: Comprehensive Arrhythmia Research and Management Center, Salt Lake City, United States ; University of Utah School of Medicine, University of Utah, Salt Lake City, UT, United States.
authors.forename: Brent
authors.initials: B
authors.lastname: Wilson
authors.affiliation: Comprehensive Arrhythmia Research and Management Center, Salt Lake City, United States ; University of Utah School of Medicine, University of Utah, Salt Lake City, UT, United States.
authors.forename: Nassir
authors.initials: N
authors.lastname: Marrouche
authors.affiliation: Comprehensive Arrhythmia Research and Management Center, Salt Lake City, United States ; University of Utah School of Medicine, University of Utah, Salt Lake City, UT, United States.
authors.forename: Frederick T
authors.initials: FT
authors.lastname: Han
authors.affiliation: Comprehensive Arrhythmia Research and Management Center, Salt Lake City, United States ; Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, United States ; University of Utah School of Medicine, University of Utah, Salt Lake City, UT, United States ; Department of Bioengineering, University of Utah, Salt Lake City, United States.
authors.forename: Rob S
authors.initials: RS
authors.lastname: MacLeod