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Cardiac CT for Measurement of Right Ventricular Volume and Function in Comparison with Cardiac MRI: A Meta-Analysis
Jin Young Kim1, Young Joo Suh2, Kyunghwa Han3
1Department of Radiology, Dongsan Hospital, Keimyung University College of Medicine, Daegu, Korea.
Insights
Cardiac CT accurately assesses right ventricle (RV) volume and function, showing strong agreement with cardiac magnetic resonance imaging (CMRI). Specific CT protocols and techniques enhance measurement accuracy, making CT a reliable alternative to CMRI.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- Cardiac magnetic resonance imaging (CMRI) is the reference standard for assessing right ventricle (RV) function.
- Cardiac computed tomography (CT) is increasingly used, but its agreement with CMRI for RV parameters requires evaluation.
Purpose of the Study:
- To perform a meta-analysis evaluating the agreement between cardiac CT and CMRI in assessing RV volume and functional parameters.
- To identify factors influencing the accuracy of CT in RV measurements.
Main Methods:
- Systematic literature search of PubMed, EMBASE, and Cochrane Library for comparative studies of CT and CMRI for RV end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), and ejection fraction (EF).
- Meta-analytic methods to determine pooled bias, limits of agreement (LOA), and correlation coefficients (r).
- Subgroup analyses based on CT contrast protocol, slice count, reconstruction interval, volumetry, and segmentation methods.
Main Results:
- Analysis of 20 studies with 766 patients.
- Strong pooled correlation coefficients (r = 0.87-0.93) for RV parameters.
- Acceptable pooled bias and LOA for EDV, ESV, SV, and EF.
- RV-dedicated contrast protocols, ≥ 64 CT slices, and Simpson's method for volumetry showed lower bias and narrower LOA.
Conclusions:
- Cardiac CT demonstrates accurate RV volume and function assessment with acceptable bias and LOA compared to CMRI.
- Optimized CT protocols, including RV-dedicated contrast, higher slice counts, and specific volumetry techniques, improve agreement with CMRI.
Objective:
We performed a meta-analysis to evaluate the agreement of cardiac computed tomography (CT) with cardiac magnetic resonance imaging (CMRI) in the assessment of right ventricle (RV) volume and functional parameters.
Materials And Methods:
PubMed, EMBASE, and Cochrane library were systematically searched for studies that compared CT with CMRI as the reference standard for measurement of the following RV parameters: end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), or ejection fraction (EF). Meta-analytic methods were utilized to determine the pooled weighted bias, limits of agreement (LOA), and correlation coefficient (r) between CT and CMRI. Heterogeneity was also assessed. Subgroup analyses were performed based on the probable factors affecting measurement of RV volume: CT contrast protocol, number of CT slices, CT reconstruction interval, CT volumetry, and segmentation methods.
Results:
A total of 766 patients from 20 studies were included. Pooled bias and LOA were 3.1 mL (-5.7 to 11.8 mL), 3.6 mL (-4.0 to 11.2 mL), -0.4 mL (5.7 to 5.0 mL), and -1.8% (-5.7 to 2.2%) for EDV, ESV, SV, and EF, respectively. Pooled correlation coefficients were very strong for the RV parameters (r = 0.87-0.93). Heterogeneity was observed in the studies (I² > 50%, p < 0.1). In the subgroup analysis, an RV-dedicated contrast protocol, ≥ 64 CT slices, CT volumetry with the Simpson's method, and inclusion of the papillary muscle and trabeculation had a lower pooled bias and narrower LOA.
Conclusion:
Cardiac CT accurately measures RV volume and function, with an acceptable range of bias and LOA and strong correlation with CMRI findings. The RV-dedicated CT contrast protocol, ≥ 64 CT slices, and use of the same CT volumetry method as CMRI can improve agreement with CMRI.
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