- Poster presentation
- Open Access
Precision and reproducibility of semi-automated late gadolinium enhancement quantification techniques in patients with hypertrophic cardiomyopathy
© Mikami et al.; licensee BioMed Central Ltd. 2014
- Published: 16 January 2014
- Late Gadolinium Enhancement
- Hypertrophic Cardiomyopathy
- Manual Segmentation
- Manual Assignment
- Acceptable Reproducibility
The presence and extent of hyper-enhancement (HE) on Late Gadolinium Enhancement (LGE) has been associated with adverse events in patients with Hypertrophic Cardiomyopathy (HCM). Signal-threshold techniques are routinely employed for quantification; however, the precision and reproducibility of these versus a gold standard remains uncertain. Full Width Half of Maximum (FWHM) techniques are suggested to provide greater reproducibility than Signal Threshold versus Reference Mean (STRM) techniques, however the precision of these approaches versus manual assignment of optimal signal intensity(SI) thresholds has not been studied. We compare all known semi-automated LGE-quantification techniques for precision and reproducibility among patients with HCM.
Seventy-six patients with HCM (51 male, age 54 ± 13) were studied. Endocardial and epidcardial borders were manually traced. Total HE volume was quantified using 6 semi-automated techniques and compared to expert manual adjustment of the signal intensity threshold. Techniques tested included STRM-based thresholds of > 2, 3, 5 and 6 SD above mean SI of reference myocardium, the FWHM technique, and the Otsu-auto-threshold (OAT) technique. The SI threshold applied for each slice and total HE volume were recorded. Bland-Altman analysis and intra-class correlation coefficients (ICC) were reported for each semi-automated technique versus expert, manually adjusted HE segmentation. Intra- and inter-observer reproducibility assessments were performed.
FWHM segmentation provides superior reproducibility, however systematically under-estimates total HE volume compared to manual segmentation in patients with HCM. The STRM > 3SD technique provides the greatest precision while retaining acceptable reproducibility and may therefore be the preferred approach for HE quantification in this population.
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