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Semiautomatic method for peak velocity quantification using 4D flow imaging in hypertrophic cardiomyopathy with left
Xavier Desdoit1, Roger Bouzerar2, Charlotte Dantoing1
1Department of Radiology, Amiens University Hospital, 1 Rond-Point du Professeur Christian Cabrol, F-80054 Amiens Cedex 01, France.
Insights
A new semiautomatic method accurately measures left ventricular outflow tract (LVOT) peak velocity in hypertrophic cardiomyopathy patients. This faster, reproducible technique improves upon conventional, time-consuming methods for assessing LVOT obstruction.
Area of Science:
- Cardiovascular Imaging
- Cardiac MRI
- Hemodynamics
Background:
- Left ventricular outflow tract obstruction (LVOTO) is critical in managing hypertrophic cardiomyopathy (HCM).
- Current 4D flow cardiac MRI methods for measuring LVOT peak velocity are often laborious and time-consuming.
- Reliable and efficient measurement techniques are needed for accurate LVOTO assessment in HCM.
Purpose of the Study:
- To evaluate the reliability and reproducibility of a novel semiautomatic measurement method for LVOT peak velocity.
- To compare the performance of the semiautomatic method against conventional techniques.
Main Methods:
- Prospective, single-center study involving 26 patients with HCM undergoing 1.5T cardiac MRI.
- Inclusion of a free-breathing, kat-ARC accelerated 4D flow sequence.
- Analysis of anonymized MRI scans by two observers using both conventional and semiautomatic methods to quantify LVOT peak velocity and record analysis times.
Main Results:
- Excellent intraobserver agreement for both methods (ICC = 0.998 for semiautomatic, 0.905 for conventional).
- Excellent interobserver agreement for the semiautomatic method (ICC = 0.999) compared to good agreement for the conventional method (ICC = 0.859).
- Significantly shorter analysis times with the semiautomatic method (p < 10^-3).
Conclusions:
- The semiautomatic method offers a fast and reproducible approach for measuring LVOT peak velocity in HCM patients with LVOTO.
- This technique is a viable alternative to conventional methods, overcoming their time-consuming and operator-dependent limitations.
- The kat-ARC accelerated 4D flow sequence combined with semiautomatic analysis enhances efficiency in HCM assessment.
Objectives:
The presence of left ventricular outflow tract obstruction (LVOTO) is an important factor in the management of hypertrophic cardiomyopathy. Measurement of left ventricular outflow tract (LVOT) peak velocity on 4D flow cardiac magnetic resonance imaging using current postprocessing methods can be laborious and time-consuming. The purpose of this study was to assess the reliability and reproducibility of a new semiautomatic measurement method.
Materials And Methods:
This single-center prospective study included patients who underwent cardiac MRI at 1.5 T for the assessment of hypertrophic cardiomyopathy with left ventricular ejection obstruction as part of their initial assessment or follow-up. A free-breathing kat-ARC accelerated 4D flow sequence was added to the usual protocol. MRI scans were anonymized and analyzed by two observers to quantify LVOT peak velocity using conventional and semiautomatic methods. The duration of postprocessing was recorded for each method.
Results:
Twenty-six patients (60.9 ± 11 years, 11 men) were included. Intraobserver agreement was excellent for both methods but was slightly higher for the semiautomatic method than for the conventional method (Intraclass Correlation Coefficient ICC = 0.998 vs 0.905). Interobserver agreement was good for the conventional method (ICC = 0.859) and excellent for the semiautomatic method (ICC = 0.999). In addition, analysis times were significantly shorter with the semiautomatic method (p < 10-3).
Conclusion:
The semiautomatic method for measuring LVOT peak velocity on a kat-ARC accelerated 4D flow sequence in hypertrophic cardiomyopathy with left ventricular outflow tract obstruction is fast and reproducible. It is an alternative to the conventional quantification method, which is time-consuming and operator dependent.
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