MDCT Derived Left Ventricular Function in Relation to Echocardiography: Validation and Revising the Role with the...

Area of Science:

• Cardiovascular Imaging
• Medical Software Development
• Diagnostic Technology

Background:

• Coronary computed tomography angiography (CCTA) is a key diagnostic tool for coronary artery disease.
• Retrospective gating in CCTA allows for the derivation of left ventricular (LV) functional parameters using automated software.
• Validating these derived parameters against established standards is crucial for enhancing the utility of CCTA.

Purpose of the Study:

• To evaluate the utility of fully automated software for assessing left ventricular ejection fraction (LVEF) using 64-slice CCTA data.
• To correlate LVEF measurements derived from CCTA with those obtained from echocardiography (ECHO).
• To review the role of CT-derived LV function in the context of emerging multidetector CT (MDCT) technologies.

Main Methods:

• 113 patients undergoing 64-slice MDCT CCTA for coronary artery disease evaluation were included.
• Echocardiography (ECHO) was performed within one week of the CCTA scan for comparison.
• Automated software ('Auto ejection fraction') on an advanced workstation analyzed retrospectively ECG-gated CCTA data for LVEF calculation.

Main Results:

• Mean LVEF by ECHO was 58.6 ± 4.5%, while automated CCTA software yielded 58.9 ± 5.4%.
• Pearson's regression analysis revealed a significant correlation between CCTA and ECHO LVEF (r=0.503, P < 0.001).
• Bland-Altman analysis indicated a slight trend for CCTA to report higher LVEF values compared to ECHO.

Conclusions:

• Fully automated software provides a simple, reliable, and user-friendly method for rapid LV functional assessment with good reproducibility.
• While correlation is good, future clinical benefit may be limited by the decreasing number of CCTA studies utilizing retrospective gating.