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Published on: June 3, 2018
Validation of a Three-Dimensional Computed Tomography Reconstruction Tool for Aortic Valve Calcium Quantification
Thijmen W Hokken1, Joris F Ooms1, Isabella Kardys1
1Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands.
Insights
A new semiautomated tool for quantifying aortic valve calcium shows excellent agreement with manual methods. This finding supports its use in assessing aortic stenosis severity and predicting outcomes after transcatheter aortic valve replacement.
Area of Science:
- Cardiology
- Medical Imaging
- Computational Analysis
Background:
- Aortic valve calcification severity correlates with aortic stenosis.
- High calcium scores predict complications like conduction disturbances and paravalvular leakage post-transcatheter aortic valve replacement (TAVR).
- Multislice computed tomography (MSCT) is crucial for preprocedural planning in TAVR.
Purpose of the Study:
- To validate a semiautomated calcium quantification tool (3mensio Structural Heart) against a conventional manual method.
- To assess the accuracy and reliability of the 3mensio Structural Heart software for aortic valve calcium scoring.
Main Methods:
- Retrospective analysis of 50 patients undergoing MSCT for TAVR planning.
- Comparison of semiautomated Agatston calcium scores from 3mensio Structural Heart with manually obtained scores from IntelliSpace Portal.
- Statistical analysis including intraclass correlation coefficient (ICC) and inter/intraobserver variability.
Main Results:
- Excellent correlation (ICC=0.995) between semiautomated (3mensio) and manual (IntelliSpace) Agatston calcium scores.
- Minimal mean difference (-0.18) between the two scoring methods.
- High interobserver (0.993) and intraobserver (0.995) reliability for the semiautomated tool.
Conclusions:
- The semiautomated calcium quantification module in 3mensio Structural Heart is a highly reliable tool.
- It demonstrates excellent correlation with conventional manual calcium scoring methods.
- This validated tool can aid in assessing aortic valve stenosis severity and guiding TAVR procedures.
Background:
Aortic valve calcification correlates with the severity of aortic valve stenosis and a high calcium score is associated with conduction disturbances and paravalvular leakage after transcatheter aortic valve replacement. The 3mensio Structural Heart is a semiautomated software package to facilitate aortic root analysis by multislice computed tomography.The aim of the contemporary study is to validate a semiautomated calcium quantification scoring tool with a conventional manual calcium quantification tool.
Methods:
Fifty randomly selected patients who underwent multislice computed tomography for preprocedural planning were retrospectively selected to compare the semiautomated aortic valve Agatston calcium score by 3mensio with the manually obtained score using IntelliSpace Portal as standard reference.
Results:
Patients had a mean age of 76.7 ± 7.4 years and 60% were male. The median Agatston score was 3390 [interquartile range 1877-4509] with 3mensio and 3434 [interquartile range 1839-4620] with IntelliSpace.The mean difference was -0.18 [95% confidence interval (CI) -53.8 to 53.4]. The intraclass correlation coefficient between the Agatston scores using IntelliSpace and 3mensio showed an excellent correlation of 0.995 [95% CI 0.992-0.997], p ≤ 0.001. The interobserver and intraobserver variability was 0.993 ([95% CI 0.961-0.998], p ≤ 0.001) and 0.995([95%CI 0.981-0.999], p = <0.001), respectively.
Conclusions:
The semiautomated calcium quantification module in 3mensio Structural Heart highly correlated with a conventional manual calcium scoring tool.
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