Right ventricular function assessment: comparison of geometric and visual method to short-axis slice summation method

Area of Science:

• Cardiovascular Imaging
• Cardiac MRI Analysis
• Ventricular Function Assessment

Background:

• Current short-axis summation (SAS) method for cardiac MRI-based right ventricular (RV) volumes and ejection fraction (RVEF) is time-consuming.
• A need exists for simplified, accurate RVEF measurement techniques.
• This study evaluates two simplified methods against the established SAS approach.

Purpose of the Study:

• To compare the accuracy and reproducibility of a simplified geometric method (GM) and visual estimation against the SAS method for RVEF measurement.
• To assess the utility of these simplified methods for clinical application.

Main Methods:

• Forty patients undergoing cine cardiac MRI were analyzed using SAS, GM (ellipsoid model), and visual estimation.
• RVEF was calculated by all three methods; RV volumes were measured by SAS and GM.
• Bland-Altman analysis was employed to evaluate agreement between the measurement techniques.

Main Results:

• Mean RVEF values were similar across methods: SAS (49%), GM (54%), and visual estimate (49%).
• GM and visual estimate demonstrated comparable bias and limits of agreement to SAS for RVEF.
• Interobserver variability for RVEF was within +/-10% in most patients; however, GM showed wider limits for RV volumes and underestimated end-systolic volume.

Conclusions:

• Simplified geometric and visual estimation methods provide comparable bias and agreement to SAS for RVEF measurement.
• Despite underestimation of end-systolic volume, the geometric method shows potential for serial RV volume monitoring.