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Kirchner J, Gerçek M, Gesch J, Omran H, Friedrichs K, Rudolph F, Ivannikova M, Rossnagel T, Piran M, Pfister R, Blanke P, Rudolph V, Rudolph TK. Artificial intelligence-analyzed computed tomography in patients undergoing transcatheter tricuspid valve repair. Int J Cardiol 2024; 411:132233. [PMID: 38848770 DOI: 10.1016/j.ijcard.2024.132233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 05/26/2024] [Accepted: 06/03/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND Baseline right ventricular (RV) function derived from 3-dimensional analyses has been demonstrated to be predictive in patients undergoing transcatheter tricuspid valve repair (TTVR). The complex nature of these cumbersome analyses makes patient selection based on established imaging methods challenging. Artificial intelligence (AI)-driven computed tomography (CT) segmentation of the RV might serve as a fast and predictive tool for evaluating patients prior to TTVR. METHODS Patients suffering from severe tricuspid regurgitation underwent full cycle cardiac CT. AI-driven analyses were compared to conventional CT analyses. Outcome measures were correlated with survival free of rehospitalization for heart-failure or death after TTVR as the primary endpoint. RESULTS Automated AI-based image CT-analysis from 100 patients (mean age 77 ± 8 years, 63% female) showed excellent correlation for chamber quantification compared to conventional, core-lab evaluated CT analysis (R 0.963-0.966; p < 0.001). At 1 year (mean follow-up 229 ± 134 days) the primary endpoint occurred significantly more frequently in patients with reduced RV ejection fraction (EF) <50% (36.6% vs. 13.7%; HR 2.864, CI 1.212-6.763; p = 0.016). Furthermore, patients with dysfunctional RVs defined as end-diastolic RV volume > 210 ml and RV EF <50% demonstrated worse outcome than patients with functional RVs (43.7% vs. 12.2%; HR 3.753, CI 1.621-8.693; p = 0.002). CONCLUSIONS Derived RVEF and dysfunctional RV were predictors for death and hospitalization after TTVR. AI-facilitated CT analysis serves as an inter- and intra-observer independent and time-effective tool which may thus aid in optimizing patient selection prior to TTVR in clinical routine and in trials.
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Affiliation(s)
- Johannes Kirchner
- Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum, NRW, Ruhr-Universität Bochum, Med. Fakultät OWL (Universität Bielefeld), Bad Oeynhausen, Germany.
| | - Muhammed Gerçek
- Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum, NRW, Ruhr-Universität Bochum, Med. Fakultät OWL (Universität Bielefeld), Bad Oeynhausen, Germany
| | - Johannes Gesch
- Department of Cardiology, Heart Center, University of Cologne, Cologne, Germany
| | - Hazem Omran
- Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum, NRW, Ruhr-Universität Bochum, Med. Fakultät OWL (Universität Bielefeld), Bad Oeynhausen, Germany
| | - Kai Friedrichs
- Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum, NRW, Ruhr-Universität Bochum, Med. Fakultät OWL (Universität Bielefeld), Bad Oeynhausen, Germany
| | - Felix Rudolph
- Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum, NRW, Ruhr-Universität Bochum, Med. Fakultät OWL (Universität Bielefeld), Bad Oeynhausen, Germany
| | - Maria Ivannikova
- Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum, NRW, Ruhr-Universität Bochum, Med. Fakultät OWL (Universität Bielefeld), Bad Oeynhausen, Germany
| | - Tobias Rossnagel
- Department of Radiology, Nuclear Medicine and Molecular Imaging, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany
| | - Misagh Piran
- Department of Radiology, Nuclear Medicine and Molecular Imaging, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany
| | - Roman Pfister
- Department of Cardiology, Heart Center, University of Cologne, Cologne, Germany
| | - Philipp Blanke
- Center for Cardiovascular Innovation and Department of Radiology, St. Paul's Hospital and University of British Columbia, Vancouver, BC, Canada
| | - Volker Rudolph
- Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum, NRW, Ruhr-Universität Bochum, Med. Fakultät OWL (Universität Bielefeld), Bad Oeynhausen, Germany
| | - Tanja K Rudolph
- Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum, NRW, Ruhr-Universität Bochum, Med. Fakultät OWL (Universität Bielefeld), Bad Oeynhausen, Germany
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Tang L, Diao K, Deng Q, Wu X, Peng P, Yue X, Wu T, Cheng W, Li Y, Zhou X, Wetzl J, Chen Y, Yue W, Sun J. Comparison between pre- and post-contrast cardiac MRI cine images: the impact on ventricular volume and strain measurement. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2023; 39:1055-1064. [PMID: 36840896 DOI: 10.1007/s10554-023-02809-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 02/04/2023] [Indexed: 02/26/2023]
Abstract
To explore whether contrast agent administration will affect ventricular volume and strain parameters measured on cardiac magnetic resonance cine images. This prospective study enrolled 88 patients, including 32 patients with cardiac amyloidosis (CA), 32 patients with hypertrophic cardiomyopathy (HCM), and 24 control participants, to perform steady-state free precession (SSFP)-cine imaging twice, respectively before and after contrast agent injection. Indexed left and right ventricular (LV and RV) volume and LV strain parameters (peak radial strain [PRS], peak circumferential strain [PCS], peak longitudinal strain [PLS]) were analyzed and compared between the pre- and post-contrast cine groups. Compared to the group of pre-contrast cine, the end-diastolic volume index (EDVi) and end-systolic volume index (ESVi) significantly increased in the group using post-contrast cine images (all p < 0.05), especially in the right ventricle. After contrast injection, the right ventricular ejection fraction (RVEF) decreased significantly (p < 0.05), while the left ventricular ejection fraction (LVEF) only reduced for patients with HCM (p < 0.05). The PRS (37.1 ± 15.2 vs. 32.0 ± 15.4, p < 0.001) and PCS (- 14.9 ± 4.3 vs. - 14.0 ± 4.1, p < 0.001) derived from post-contrast cine images reduced significantly in all patients and this tendency remained in subgroup analysis except for PCS in the control group. The administration of a contrast agent may influence the measurements of ventricular volume and strain. Acquiring pre-contrast cine images were suggested for patients who required more accurate right ventricle evaluation or precise strain assessment.
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Affiliation(s)
- Lu Tang
- Department of Radiology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Kaiyue Diao
- Department of Radiology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Qiao Deng
- Department of Radiology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Xi Wu
- Department of Radiology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Pengfei Peng
- Department of Radiology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Xun Yue
- Department of Radiology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Tao Wu
- Department of Radiology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Wei Cheng
- Department of Radiology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Yangjie Li
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoyue Zhou
- MR Collaboration, Siemens Healthineers Ltd, Shanghai, China
| | - Jens Wetzl
- MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Yucheng Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Wenjun Yue
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Jiayu Sun
- Department of Radiology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
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Kim JY, Suh YJ, Han K, Kim YJ, Choi BW. Cardiac CT for Measurement of Right Ventricular Volume and Function in Comparison with Cardiac MRI: A Meta-Analysis. Korean J Radiol 2020; 21:450-461. [PMID: 32193893 PMCID: PMC7082652 DOI: 10.3348/kjr.2019.0499] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 12/16/2019] [Indexed: 11/18/2022] Open
Affiliation(s)
- Jin Young Kim
- Department of Radiology, Dongsan Hospital, Keimyung University College of Medicine, Daegu, Korea
| | - Young Joo Suh
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
| | - Kyunghwa Han
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Young Jin Kim
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Byoung Wook Choi
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Accuracy of right ventricular volume and function assessed with cardiovascular magnetic resonance: comparison with echocardiographic parameters. Clin Imaging 2020; 59:61-67. [DOI: 10.1016/j.clinimag.2019.10.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 09/11/2019] [Accepted: 10/18/2019] [Indexed: 11/18/2022]
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CT compared to MRI for functional evaluation of the right ventricle: a systematic review and meta-analysis. Eur Radiol 2019; 29:6816-6828. [PMID: 31134368 DOI: 10.1007/s00330-019-06228-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 03/25/2019] [Accepted: 04/05/2019] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Right ventricular function (RVF) is a strong predictor of adverse cardiac events; however, the reference standard for RVF assessment, MRI, is limited in some patients for whom accurate evaluation of RVF is essential, like those with COPD or non-MR compatible metal implants. We conducted this meta-analysis to evaluate whether CT was as accurate as MRI for the assessment of RVF. METHOD We conducted a meta-analysis of studies retrieved from PubMed, Embase, and Cochrane Central searches to evaluate the differences and correlations between the following RVF parameters as measured by CT and MRI: end diastole volume (EDV), end systole volume (ESV), right ventricular ejection fraction (RVEF), and stroke volume (SV). RESULTS Sixteen studies that used disk summation (637 subjects) and three studies that used three-dimensional reconstruction were included. For the 16 studies, the pooled standard mean differences (95% confidence interval) were 1.04 (- 2.59, 4.67) for EDV, 1.22 (1.50, 3.95) for ESV, - 0.65 (- 2.60, 1.29) for RVEF, and - 0.37 (- 3.64, 2.90) for SV. The overall correlation coefficient (r) values were 0.98 for EDV, 0.95 for ESV, 0.98 for RVEF, and 0.97 for SV. The mean difference between the two methods was not statistically significant (overall effect Z test, p > 0.1). CONCLUSION CT can assess RVF with accuracy comparable to that of MRI. Thus, CT is a valid alternative to MRI. KEY POINTS • CT could help clinicians to assess RVF as accurately as MRI can, with satisfactory repeatability.
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Grosse A, Grosse C, Lang I. Evaluation of the CT imaging findings in patients newly diagnosed with chronic thromboembolic pulmonary hypertension. PLoS One 2018; 13:e0201468. [PMID: 30059549 PMCID: PMC6066236 DOI: 10.1371/journal.pone.0201468] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 07/16/2018] [Indexed: 01/10/2023] Open
Abstract
PURPOSE The aim of this study was to evaluate the vascular and parenchymal CT imaging findings, including vessel and cardiac chamber diameter measurements, in patients newly diagnosed with chronic thromboembolic pulmonary hypertension (CTEPH). The CT imaging findings were correlated with hemodynamic measurements and patient outcome. METHODS Vascular and parenchymal CT findings were assessed on retrospectively ECG-gated MDCT angiography scans in 76 patients newly diagnosed with CTEPH. The diameters of the right and left ventricle (dRV, dLV), the right and left atrium (dRA, dLA), the ascending aorta (dAA), the right and left pulmonary arteries (drPA, dlPA), and the main pulmonary artery (dPA) were measured on axial CT scans. The CT imaging findings were correlated with demographic and hemodynamic data and adverse patient outcome due to right heart failure (RHF). RESULTS The majority of patients showed chronic PE, mosaic perfusion, disparity in segmental vessel size, parenchymal densities, bronchial dilatation, and bronchial collaterals in CT. Mean pulmonary artery pressure (mPAP) was not significantly different in patients with and those without chronic PE, mosaic perfusion, disparity in segmental vessel size, parenchymal densities, bronchial dilatation, and bronchial collaterals. Mean PAP showed significant correlations with the CT metrics of dRV/dLV ratio, dRA, dRV, dPA and dPA/dAA ratio, but no correlation with the central thrombi score. By backward linear regression, the dPA/dAA ratio independently correlated with mPAP. Patients who died of RHF tended to have a higher frequency of exclusively chronic peripheral PE and greater dRV/dLV ratios on presenting CT scans compared with survivors. CONCLUSION The majority of patients newly diagnosed with CTEPH show vascular signs of chronic PE, mosaic perfusion, parenchymal densities, disparity in segmental vessel size, bronchial dilatation, and bronchial collaterals on presenting CT scans. Particularly CTEPH patients with exclusively chronic peripheral PE and increased dRV/dLV ratios seem to be at risk of adverse outcome due to RHF.
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Affiliation(s)
- Alexandra Grosse
- Department of Radiology, Medical University of Vienna, Vienna, Austria
| | - Claudia Grosse
- Department of Radiology, Medical University of Vienna, Vienna, Austria
- * E-mail:
| | - Irene Lang
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
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John G, Marti C, Poletti PA, Perrier A. Hemodynamic indexes derived from computed tomography angiography to predict pulmonary embolism related mortality. BIOMED RESEARCH INTERNATIONAL 2014; 2014:363756. [PMID: 25147798 PMCID: PMC4087299 DOI: 10.1155/2014/363756] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 06/02/2014] [Indexed: 12/05/2022]
Abstract
Pulmonary embolism (PE) induces an acute increase in the right ventricle afterload that can lead to right-ventricular dysfunction (RVD) and eventually to circulatory collapse. Hemodynamic status and presence of RVD are important determinants of adverse outcomes in acute PE. Technologic progress allows computed tomography angiography (CTA) to give more information than accurate diagnosis of PE. It may also provide an insight into hemodynamics and right-ventricular function. Proximal localization of emboli, reflux of contrast medium to the hepatic veins, and right-to-left short-axis ventricular diameter ratio seem to be the most relevant CTA predictors of 30-day mortality. These elements require little postprocessing time, an advantage in the emergency room. We herein review the prognostic value of RVD and other CTA mortality predictors for patients with acute PE.
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Affiliation(s)
- Gregor John
- Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals (HUG), Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
| | - Christophe Marti
- Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals (HUG), Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
| | - Pierre-Alexandre Poletti
- Department of Radiology, Emergency-Room Radiology Unit, Geneva University Hospitals (HUG), Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
| | - Arnaud Perrier
- Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals (HUG) and Geneva Faculty of Medicine, Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland
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Wang L, Zhang Y, Yan C, He J, Xiong C, Zhao S, Fang W. Evaluation of right ventricular volume and ejection fraction by gated (18)F-FDG PET in patients with pulmonary hypertension: comparison with cardiac MRI and CT. J Nucl Cardiol 2013; 20:242-52. [PMID: 23354658 DOI: 10.1007/s12350-013-9672-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2012] [Accepted: 01/02/2013] [Indexed: 10/27/2022]
Abstract
BACKGROUND Right ventricular (RV) function is a powerful predictor of survival in patients with pulmonary hypertension (PH), but noninvasively assessing RV function remains a challenge. The aim of this study was to prospectively compare gated (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) myocardial imaging (gated PET), cardiac magnetic resonance (CMR), and cardiac computed tomography (CCT) for the assessment of RV volume and ejection fraction in patients with PH. METHODS Twenty-three consecutive patients aged more than 16 years diagnosed with PH were included. All patients underwent gated PET, CMR, and CCT within 7 days. Right ventricular end-diastolic volume (RVEDV), right ventricular end-systolic volume (RVESV), and right ventricular ejection fraction (RVEF) were calculated by three imaging modalities. RV (18)F-FDG uptake was determined as RV-corrected standardized uptake value (SUV), and the ratio of RV to left ventricular (LV)-corrected SUV (Corrected SUV R/L). RESULTS Gated PET showed a moderate correlation (r = 0.680, P < .001) for RVEDV, good correlation for RVESV (r = 0.757, P < .001) and RVEF (r = 0.788, P < .001) with CMR, and good correlation for RVEDV (r = 0.767, P < .001), RVESV (r = 0.837, P < .001), and RVEF (r = 0.730, P < .001) with CCT. Bland-Altman analysis revealed systematic underestimation of RVEDV and RVESV and overestimation of RVEF with gated PET compared with CMR and CCT. The correlation between RVESV (r = 0.863, P < .001), RVESV (r = 0.903, P < .001), and RVEF (r = 0.853, P < .001) of CMR and those of CCT was excellent; Bland-Altman analysis showed only a slight systematic variation between CMR and CCT. There were statistically significant negative correlations between RV-corrected SUV and RVEF-CMR (r = -0.543, P < .01), Corrected SUV R/L and RVEF-CMR (r = -0.521, P < .05), RV-corrected SUV and RVEF-CCT (r = -0.429, P < .05), Corrected SUV R/L and RVEF-CCT (r = -0.580, P < .01), respectively. CONCLUSION Gated PET had moderate-to-high correlation with CMR and CCT in the assessments of RV volume and ejection fraction. It is an available method for simultaneous assessing of RV function and myocardial glucose metabolism in patients with PH.
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Affiliation(s)
- Lei Wang
- Department of Nuclear Medicine, Cardiovascular Institute and Fu Wai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 167 Beilishi Road, Beijing, 100037, China
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Rief M, Stenzel F, Kranz A, Schlattmann P, Dewey M. Time efficiency and diagnostic accuracy of new automated myocardial perfusion analysis software in 320-row CT cardiac imaging. Korean J Radiol 2012; 14:21-9. [PMID: 23323027 PMCID: PMC3542299 DOI: 10.3348/kjr.2013.14.1.21] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Accepted: 08/02/2012] [Indexed: 01/29/2023] Open
Abstract
Objective We aimed to evaluate the time efficiency and diagnostic accuracy of automated myocardial computed tomography perfusion (CTP) image analysis software. Materials and Methods 320-row CTP was performed in 30 patients, and analyses were conducted independently by three different blinded readers by the use of two recent software releases (version 4.6 and novel version 4.71GR001, Toshiba, Tokyo, Japan). Analysis times were compared, and automated epi- and endocardial contour detection was subjectively rated in five categories (excellent, good, fair, poor and very poor). As semi-quantitative perfusion parameters, myocardial attenuation and transmural perfusion ratio (TPR) were calculated for each myocardial segment and agreement was tested by using the intraclass correlation coefficient (ICC). Conventional coronary angiography served as reference standard. Results The analysis time was significantly reduced with the novel automated software version as compared with the former release (Reader 1: 43:08 ± 11:39 min vs. 09:47 ± 04:51 min, Reader 2: 42:07 ± 06:44 min vs. 09:42 ± 02:50 min and Reader 3: 21:38 ± 3:44 min vs. 07:34 ± 02:12 min; p < 0.001 for all). Epi- and endocardial contour detection for the novel software was rated to be significantly better (p < 0.001) than with the former software. ICCs demonstrated strong agreement (≥ 0.75) for myocardial attenuation in 93% and for TPR in 82%. Diagnostic accuracy for the two software versions was not significantly different (p = 0.169) as compared with conventional coronary angiography. Conclusion The novel automated CTP analysis software offers enhanced time efficiency with an improvement by a factor of about four, while maintaining diagnostic accuracy.
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Affiliation(s)
- Matthias Rief
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin 10117, Germany
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Fuchs A, Kühl JT, Lønborg J, Engstrøm T, Vejlstrup N, Køber L, Kofoed KF. Automated assessment of heart chamber volumes and function in patients with previous myocardial infarction using multidetector computed tomography. J Cardiovasc Comput Tomogr 2012; 6:325-34. [DOI: 10.1016/j.jcct.2012.01.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Revised: 12/11/2011] [Accepted: 01/22/2012] [Indexed: 10/27/2022]
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Caudron J, Fares J, Lefebvre V, Vivier PH, Petitjean C, Dacher JN. Cardiac MRI assessment of right ventricular function in acquired heart disease: factors of variability. Acad Radiol 2012; 19:991-1002. [PMID: 22608861 DOI: 10.1016/j.acra.2012.03.022] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Revised: 03/15/2012] [Accepted: 03/17/2012] [Indexed: 10/28/2022]
Abstract
RATIONALE AND OBJECTIVES To evaluate intra- and inter-observer variability of right ventricular (RV) functional parameters as evaluated by cardiac magnetic resonance imaging (MRI) in patients with acquired heart disease (AHD), and to identify factors associated with an increased variability. MATERIALS AND METHODS Sixty consecutive patients were enrolled. Right and left ventricular (LV) volumes, ejection fraction, and mass were determined from short-axis cine sequences. All analyzes were performed twice by three observers with various training-degree in cardiac MRI. Intra- and inter-observer variability was evaluated. The impact on variability of each of the following parameters was assessed: observer's experience, basal and apical slices selection, end-systolic phase selection, and delineation. RESULTS Mean segmentation time ranged 9.8-19.0 minutes for RV and 6.4-9.2 minutes for LV. Variability of RV functional parameters measurement was strongly influenced by previous observer's experience: it was two to three times superior to that of LV, even for the most experienced observer. High variability in the measurement of RV mass was observed. For both ventricles, selection of the basal slice and delineation were major determinants of variability. CONCLUSION As compared to LV, RV function assessment with cardiac MRI in AHD patients is much more variable and time-consuming. Observer's experience, selection of basal slice, and delineation are determinant.
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Maffei E, Messalli G, Martini C, Nieman K, Catalano O, Rossi A, Seitun S, Guaricci AI, Tedeschi C, Mollet NR, Cademartiri F. Left and right ventricle assessment with Cardiac CT: validation study vs. Cardiac MR. Eur Radiol 2012; 22:1041-9. [PMID: 22270140 PMCID: PMC3321142 DOI: 10.1007/s00330-011-2345-6] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2011] [Revised: 10/05/2011] [Accepted: 10/08/2011] [Indexed: 12/03/2022]
Abstract
Objectives To compare Magnetic Resonance (MR) and Computed Tomography (CT) for the assessment of left (LV) and right (RV) ventricular functional parameters. Methods Seventy nine patients underwent both Cardiac CT and Cardiac MR. Images were acquired using short axis (SAX) reconstructions for CT and 2D cine b-SSFP (balanced-steady state free precession) SAX sequence for MR, and evaluated using dedicated software. Results CT and MR images showed good agreement: LV EF (Ejection Fraction) (52 ± 14% for CT vs. 52 ± 14% for MR; r = 0.73; p > 0.05); RV EF (47 ± 12% for CT vs. 47 ± 12% for MR; r = 0.74; p > 0.05); LV EDV (End Diastolic Volume) (74 ± 21 ml/m² for CT vs. 76 ± 25 ml/m² for MR; r = 0.59; p > 0.05); RV EDV (84 ± 25 ml/m² for CT vs. 80 ± 23 ml/m² for MR; r = 0.58; p > 0.05); LV ESV (End Systolic Volume)(37 ± 19 ml/m² for CT vs. 38 ± 23 ml/m² for MR; r = 0.76; p > 0.05); RV ESV (46 ± 21 ml/m² for CT vs. 43 ± 18 ml/m² for MR; r = 0.70; p > 0.05). Intra- and inter-observer variability were good, and the performance of CT was maintained for different EF subgroups. Conclusions Cardiac CT provides accurate and reproducible LV and RV volume parameters compared with MR, and can be considered as a reliable alternative for patients who are not suitable to undergo MR. Key Points • Cardiac-CT is able to provide Left and Right Ventricular function. • Cardiac-CT is accurate as MR for LV and RV volume assessment. • Cardiac-CT can provide accurate evaluation of coronary arteries and LV and RV function. Electronic supplementary material The online version of this article (doi:10.1007/s00330-011-2345-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Erica Maffei
- Cardiovascular Radiology Unit, Giovanni XXIII Hospital, 31050, Monastier di Treviso, Italy
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Achenbach S. Imaging of Cardiac Function by Computed Tomography. CURRENT CARDIOVASCULAR IMAGING REPORTS 2011. [DOI: 10.1007/s12410-011-9110-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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van der Bijl N, Klok FA, Huisman MV, van Rooden JK, Mertens BJ, de Roos A, Kroft LJ. Measurement of Right and Left Ventricular Function by ECG-Synchronized CT Scanning in Patients With Acute Pulmonary Embolism. Chest 2011; 140:1008-1015. [DOI: 10.1378/chest.10-3174] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Caudron J, Fares J, Vivier PH, Lefebvre V, Petitjean C, Dacher JN. Diagnostic accuracy and variability of three semi-quantitative methods for assessing right ventricular systolic function from cardiac MRI in patients with acquired heart disease. Eur Radiol 2011; 21:2111-20. [PMID: 21614615 DOI: 10.1007/s00330-011-2152-0] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2011] [Revised: 04/04/2011] [Accepted: 04/27/2011] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To evaluate the diagnostic accuracy and variability of 3 semi-quantitative (SQt) methods for assessing right ventricular (RV) systolic function from cardiac MRI in patients with acquired heart disease: tricuspid annular plane systolic excursion (TAPSE), RV fractional-shortening (RVFS) and RV fractional area change (RVFAC). METHODS Sixty consecutive patients were enrolled. Reference RV ejection fraction (RVEF) was determined from short axis cine sequences. TAPSE, RVFS and RVFAC were measured on a 4-chamber cine sequence. All SQt analyses were performed twice by 3 observers with various degrees of training in cardiac MRI. Correlation with RVEF, intra- and inter-observer variability, and receiver operating characteristic (ROC) curve analysis were performed for each SQt method. RESULTS Correlation between RVFAC and RVEF was good for all observers and did not depend on previous cardiac MRI experience (R range = 0.716-0.741). Conversely, RVFS (R range = 0.534-0.720) and TAPSE (R range = 0.482-0.646) correlated less with RVEF and depended on previous experience. Intra- and inter-observer variability was much lower for RVFAC than for RVFS and TAPSE. ROC analysis demonstrated that RVFAC <41% could predict a RVEF <45% with 90% sensitivity and 94% specificity. CONCLUSIONS RVFAC appears to be more accurate and reproducible than RVFS and TAPSE for SQt assessment of RV function by cardiac MRI.
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Affiliation(s)
- Jérôme Caudron
- Department of Radiology, University Hospital of Rouen, Rouen Cedex, France.
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van der Bijl N, Geleijns J, Joemai RMS, Bax JJ, Schuijf JD, de Roos A, Kroft LJM. Recent developments in cardiac CT. ACTA ACUST UNITED AC 2011. [DOI: 10.2217/iim.11.7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Annular Tilt as a Screening Test for Right Ventricular Enlargement in Patients with Tetralogy of Fallot. J Am Soc Echocardiogr 2010; 23:1297-302. [DOI: 10.1016/j.echo.2010.09.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Indexed: 10/18/2022]
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Gutte H, Mortensen J, Jensen CV, Von Der Recke P, Petersen CL, Kristoffersen US, Kjaer A. ANP, BNP and D-dimer predict right ventricular dysfunction in patients with acute pulmonary embolism. Clin Physiol Funct Imaging 2010; 30:466-72. [DOI: 10.1111/j.1475-097x.2010.00967.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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