Related Experiment Video
Updated: Sep 19, 2025
MRI and PET in Mouse Models of Myocardial Infarction
Published on: December 19, 2013
Ex-vivo validation of nine algorithms for quantifying infarcts with late gadolinium enhancement cardiovascular
Sascha Kopic1, Einar Heiberg2, Henrik Engblom1
1Lund University, Department of Clinical Sciences Lund, Clinical Physiology, Skane University Hospital, Lund, Sweden.
Insights
Comparing infarct size algorithms in cardiovascular magnetic resonance, this study found that Expectation Maximization-weighted A Priori information (EWA), Heiberg-08, Full-Width at Half-Maximum (FWHM), and Feature Analysis and Combined Thresholding (FACT) perform similarly to manual delineation. However, Heiberg-08 and FWHM are not suitable for all imaging types.
Area of Science:
- Cardiovascular Imaging
- Medical Image Analysis
- Cardiac MRI
Background:
- Late gadolinium enhancement (LGE) is standard for visualizing myocardial infarction (MI) in cardiovascular magnetic resonance.
- Numerous algorithms exist for quantifying infarct size in LGE images, but few are validated against ex-vivo measurements.
- Reported algorithm performance varies significantly across studies.
Purpose of the Study:
- To compare the performance of all available infarct measurement algorithms against ex-vivo measurements.
- To facilitate a discussion on the advantages and disadvantages of different infarct measurement methods.
- To establish benchmarks for algorithm performance in infarct size quantification.
Main Methods:
- Myocardial infarction (MI) was induced in 22 pigs, with in-vivo LGE imaging performed at varying time points post-MI.
- Ex-vivo validation involved high-resolution T1-weighted imaging for infarct measurement.
- In-vivo infarct size was assessed using multiple algorithms (FWHM, n-SD, FACT, EWA, Heiberg-08, Otsu) and manual delineation, without manual adjustments to algorithm outputs.
Main Results:
- Significant variations in bias and variance were observed among the algorithm-based methods.
- Expectation Maximization-weighted A Priori information (EWA), Full-Width at Half-Maximum (FWHM), and Feature Analysis and Combined Thresholding (FACT) showed biases of -0.48±3.1%, -0.3±4.4%, and 2.3±4.2% of the left ventricle, respectively.
- Manual delineation by experienced observers demonstrated a comparable bias of 1.9±5.4%.
Conclusions:
- EWA, Heiberg-08, FWHM, and FACT algorithms demonstrate performance comparable to manual delineation for infarct size measurement.
- Heiberg-08 and FWHM algorithms are unsuitable for phase-sensitive inversion recovery images.
- Transparency in infarct quantification methods is crucial for clinical trials and research; manual delineation by experienced readers remains a reliable standard.
Background:
In cardiovascular magnetic resonance, late gadolinium enhancement (LGE) is the standard method to visualize myocardial infarction (MI). Many algorithms quantifying infarct size in LGE images exist. However, only few algorithms have been validated, i.e., benchmarked against an ex-vivo measurement. Furthermore, the reported algorithm performance varies considerably between studies.
Objectives:
The aim of this study was to compare the performance of all infarct measurement algorithms against an ex-vivo measurement and to promote a discourse regarding advantages and disadvantages of individual measurement methods.
Methods:
MI was induced in 22 pigs. In-vivo LGE imaging was conducted on d0, d3 or d7 post-MI. For ex-vivo validation infarct was measured using high-resolution T1-weighted images. In-vivo infarct size was measured using the full-width at half-maximum (FWHM), n-SD from remote (2,3,5, and 6 SD), feature analysis and combined thresholding (FACT), expectation maximization-weighted A priori information (EWA), Heiberg-08 and Otsu algorithms and manual delineation. No manual adjustments were made to algorithm delineations.
Results:
Clear differences in variance and bias were observed between algorithm-based methods, and no method performed optimally in this heterogeneous dataset where the best had a bias of -0.48±3.1, -0.3±4.4%, 2.3±4.2% left ventricle for EWA, FWHM, and FACT, respectively. Manual delineation by experienced observers performed well with a bias of 1.9±5.4%.
Conclusion:
EWA, Heiberg-08, FWHM, and FACT all perform on par with manual delineation, however, Heiberg-08, and FWHM are not suitable for phase sensitive inversion recovery images. The technique used to measure infarct size should be disclosed in clinical trials and in original research. Caution should be applied when comparing datasets employing different infarct quantification methods. Manual infarct delineation by experienced readers remains a reliable technique to measure infarct size.
More Related Videos
08:13In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
12:15Tissue Preparation Techniques for Contrast-Enhanced Micro Computed Tomography Imaging of Large Mammalian Cardiac Models with Chronic Disease
Published on: February 8, 2022
Related Concept Videos
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:21Imaging Studies for Cardiovascular System IV: CMRI