Cardiac MRI: An Alternative Method to Determine the Left Ventricular Function

Area of Science:

• Cardiology
• Medical Imaging
• Computational Anatomy

Background:

• Conventional contour surface method (KfM) for cardiac function evaluation includes papillary muscle in left ventricular volume, causing systematic error.
• Pixel-based method (PbM) offers a potential solution by excluding papillary muscle volume.
• Accurate assessment of left ventricular cardiac function is crucial for patient management and therapy decisions.

Purpose of the Study:

• To compare the accuracy of the pixel-based method (PbM) against the conventional contour surface method (KfM) for cardiac function parameters.
• To evaluate the impact of papillary muscle volume exclusion on left ventricular volume and ejection fraction measurements.
• To assess the time efficiency of the PbM compared to established methods.

Main Methods:

• Retrospective analysis of 191 cardiac MRI datasets (126 male, 65 female; age 20-75).
• Determination of left ventricular function parameters (ESV, EDV, EF, SV) using both PbM and conventional KfM (syngo.via, cvi42).
• Automatic segmentation and calculation of papillary muscle volume; recording of evaluation time for PbM.

Main Results:

• Pixel-based evaluation yielded EDV 177 mL, ESV 87 mL, SV 88 mL, and EF 50%.
• Conventional methods (cvi42/syngo.via) showed higher EDV and ESV, and lower EF (45-47%).
• PbM resulted in a significantly higher ejection fraction (average 6% increase) due to papillary muscle exclusion, with comparable stroke volume results. PbM evaluation averaged 2:02 minutes.

Conclusions:

• Pixel-based method (PbM) is a fast and easy approach for determining left ventricular cardiac function.
• PbM provides comparable stroke volume results to KfM while measuring 'true' left ventricular function by excluding papillary muscles.
• The higher ejection fraction measured by PbM can significantly influence therapeutic decisions in cardiology.