Three-Dimensional Echocardiographic Automated Quantification of Left Heart Chamber Volumes Using an Adaptive Analytics Algorithm: Feasibility and Impact of Image Quality in Nonselected Patients
| Autor: | Eric Kruse, Alma Nelson, Masaaki Takeuchi, Megan Yamat, Lynn Weinert, Diego Medvedofsky, Roberto M. Lang, Isida Byku, Kyoko Otani, Boguslawa Ciszek, Amita Singh, Victor Mor-Avi |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Computer science Image quality Cardiac Volume Heart Ventricles Heart chamber Echocardiography Three-Dimensional 030204 cardiovascular system & hematology Ventricular Function Left Article 03 medical and health sciences Ventricular Dysfunction Left 0302 clinical medicine Image Processing Computer-Assisted Humans Radiology Nuclear Medicine and imaging 030212 general & internal medicine Prospective Studies End-systolic volume Ejection fraction business.industry Patient Selection Reproducibility of Results Stroke Volume Middle Aged Analytics Reference values End-diastolic volume Feasibility Studies Female Cardiology and Cardiovascular Medicine business Algorithm 3d echocardiography Algorithms |
| Zdroj: | Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography. 30(9) |
| ISSN: | 1097-6795 |
| Popis: | Background Although 3D echocardiography (3DE) allows accurate and reproducible quantification of cardiac chambers, it has not been integrated into clinical practice because it relies on manual input, which interferes with workflow. A recently developed automated adaptive analytics algorithm for simultaneous quantification of left ventricular and atrial (LV, LA) volumes was found to be accurate and reproducible in patients with good images. We sought to prospectively test its feasibility and accuracy in consecutive patients in relationship with image quality and reader experience. Methods Three hundred consecutive patients underwent 3DE. Image quality was graded as poor, adequate, or good. Images were analyzed by an expert echocardiographer to obtain LV volumes and ejection fraction (EF) and LA volume using the automated analysis (HeartModel, Philips, Andover, MA) with and without editing the endocardial boundaries and using conventional manual tracing (QLAB, Philips, Andover, MA) blinded to the automated measurements as a reference. In a subgroup of 100 patients, automated analysis was repeated by two readers without 3DE experience. Results Automated analysis failed in 31/300 patients (10%). Patients with poor image quality ( n = 72, 24%) showed suboptimal agreement with the reference technique, especially for LVEF. Importantly, patients with adequate ( n = 89, 30%) and good ( n = 108, 36%) images showed small biases and excellent correlations without border corrections, which were further improved with editing. In contrast, border corrections by inexperienced readers did not improve the agreement with reference values. Conclusions Automated 3DE analysis allows accurate quantification of left-heart size and function in 66% of consecutive patients, while in the remaining patients, its performance is limited/unreliable due to image quality. Border corrections require 3DE experience to improve the accuracy of the automated measurements. In patients with sufficient image quality, this automated approach has the potential to overcome the workflow limitations of the 3D analysis in clinical practice. |
| Databáze: | OpenAIRE |
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