- Oral presentation
- Open Access
The Full Width Half Maximum technique is superior for LGE quantification regardless of its aetiology
© Flett et al; licensee BioMed Central Ltd. 2010
- Published: 21 January 2010
- Late Gadolinium Enhancement
- Hypertrophic Cardiomyopathy
- Full Width Half Maximum
- Reproducible Technique
- Remote Myocardium
No consensus exists on how to quantify late gadolinium enhancement (LGE) even though it is now the gold standard for the assessment of focal myocardial fibrosis. SCMR official reporting recommendations suggest that LGE be defined as signal intensity 2SD above remote myocardium. However, 3, 4, 5 or 6 SD, manual quantification and the Full Width Half Maximum (FWHM) technique are also used, with the FWHM technique reported to be accurate in an animal infarct model.
We sought to compare the seven LGE quantification techniques across the spectrum of disease: acute MI (AMI), chronic MI (CMI) and hypertrophic cardiomyopathy (HCM). We compared means and reproducibility.
%LGE varied substantially with the quantification method used. FWHM, manual and 6 or 5SD techniques gave statistically similar means in the 3 clinical scenarios. The 2SD technique generated %LGEs up to 2× higher than FWHM, 6SD and manual techniques, particularly in HCM. The inter-observer and intra-observer reproducibility of all LGE techniques were worse in HCM than AMI and CMI. The FWHM technique was the most reproducible technique in all 3 conditions compared to any other technique (p < 0.001). In AMI and HCM, manual quantification was the least reproducible technique.
Across the spectrum of clinical disease in which LGE quantification is important, the FWHM technique for LGE quantification gives %LGE mean results similar to manual quantification and has by far the best reproducibility regardless of underlying aetiology. SCMR recommendations for using the 2SD threshold technique should be reviewed.
This article is published under license to BioMed Central Ltd.