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Updated: Jun 10, 2025
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Effect of cross-platform variations on transthoracic echocardiography measurements and clinical diagnosis
Mohammad Saber Hashemi1, Yasaman Farsiani1, Gregg S Pressman2
1Department of Biomedical Engineering, University of California Irvine, Irvine, CA, USA.
Insights
Echocardiography system variations exist, impacting cardiac measurements. Philips and Canon systems showed differences in left ventricular end-diastolic volume and strain metrics, requiring consideration for patient follow-up.
Area of Science:
- Cardiovascular Imaging
- Medical Device Technology
- Echocardiography
Background:
- Accurate cardiac chamber quantification is crucial for clinical decision-making.
- Consistency in measurements across different echocardiography systems is highly desirable.
- Variations between ultrasound machines can affect diagnostic accuracy and patient management.
Purpose of the Study:
- To evaluate inter-system variations between Philips EPIQ CVx and Canon Aplio i900 echocardiography systems.
- To compare measurements of cardiac volumes, ventricular function, and valve structures.
- To identify potential discrepancies impacting clinical use and patient follow-up.
Main Methods:
- A single-centre, gender-balanced study included 40 healthy volunteers (20 female, 20 male, aged ≥40 years).
- Participants underwent alternating scans on Philips EPIQ CVx (v9.0.3) and Canon Aplio i900 (v7.0) using identical settings for 2D and 4D acquisitions.
- Paired t-tests, correlation, and Bland-Altman plots analyzed differences in left ventricular (LV) and right ventricular (RV) volumes, function, and valve anatomy.
Main Results:
- No significant differences were observed in LV end-systolic volume or LV ejection fraction between the platforms.
- Significant differences were found in LV end-diastolic volume (LVEDV) (biplane: P=0.018; 4D: P=0.028).
- Disparities noted in RV volumes (2D vs. 4D within platforms, P<0.01), LV systolic dyssynchrony index (P=0.03), LV longitudinal strain (P=0.04), LV twist (P=0.004), and LV torsion (P=0.005). Valve structure assessment varied, with more abnormalities on the Philips platform.
Conclusions:
- While LV and RV volumetric measurements are generally comparable, significant inter-system differences exist for LVEDV and LV strain metrics.
- Notable variations were observed in 2D versus 4D measurements within platforms.
- Clinicians should consider these platform-specific variations when interpreting echocardiographic data for patient follow-up and management.
Aims:
Accurate cardiac chamber quantification is essential for clinical decisions and ideally should be consistent across different echocardiography systems. This study evaluates variations between the Philips EPIQ CVx (version 9.0.3) and Canon Aplio i900 (version 7.0) in measuring cardiac volumes, ventricular function, and valve structures.
Methods And Results:
In this gender-balanced, single-centre study, 40 healthy volunteers (20 females and 20 males) aged 40 years and older (mean age 56.75 ± 11.57 years) were scanned alternately with both systems by the same sonographer using identical settings for both 2D and 4D acquisitions. We compared left ventricular (LV) and right ventricular (RV) volumes using paired t-tests, with significance set at P < 0.05. Correlation and Bland-Altman plots were used for quantities showing significant differences. Two board-certified cardiologists evaluated valve anatomy for each platform. The results showed no significant differences in LV end-systolic volume and LV ejection fraction between platforms. However, LV end-diastolic volume (LVEDV) differed significantly (biplane: P = 0.018; 4D: P = 0.028). Right ventricular (RV) measurements in 4D showed no significant differences, but there were notable disparities in 2D and 4D volumes within each platform (P < 0.01). Significant differences were also found in the LV systolic dyssynchrony index (P = 0.03), LV longitudinal strain (P = 0.04), LV twist (P = 0.004), and LV torsion (P = 0.005). Valve structure assessments varied, with more abnormalities noted on the Philips platform.
Conclusion:
Although LV and RV volumetric measurements are generally comparable, significant differences in LVEDV, LV strain metrics, and 2D vs. 4D measurements exist. These variations should be considered when using different platforms for patient follow-ups.
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