Evaluation of new software for angiographic determination of right ventricular volumes

The scope of the study was to evaluate a recent software for angiographic volume determination as compared to cardiovascular magnetic resonance imaging.

A new right ventricular analysis software closes a diagnostic gap in quantitative angiography. Cardiovascular magnetic resonance imaging short axis multi slice summation is a validated reference standard.

Right ventricular angiograms were acquired in frontal and lateral projection in 15 pediatric and 17 adult patients. Additional angiograms were acquired in RAO30 degrees /LAO60 degrees projections in 10 adult patients. The tested models comprised area length with different regressions, multi-slice with different regressions, Boak, and pyramid method. Original regressions were used to calculate angiographic right ventricular volume. Right ventricular reference volumes were determined by multi-slice summation from cardiac magnetic resonance short-axis images.

Mean inter-observer difference was -1 ml (95% confidence: -35-34 ml) and mean intra-observer difference was 0 ml (95% confidence: -22-22 ml). There was no significant difference (4 ml, 95% confidence: -22-30 ml) between geometric calibration and calibration by a sphere. The area length and multi-slice models demonstrated the best agreement with the cardiac magnetic resonance reference. Performance was best for the Onnasch Lange models.

The evaluated software provides acceptably accurate volume estimates for the majority of ventricles. In a few cases larger errors may occur, however. The area length and multi-slice models preferably with Onnasch Lange regressions may be recommended. Inter- and intra-observer agreement were excellent. Geometric calibration using data from DICOM header files may be used.