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On-line automated border detection for echocardiographic quantification of right ventricular size and function in
W A Helbing1, H G Bosch, C Maliepaard
1Department of Pediatrics (Division of Pediatric Cardiology), University Hospital Leiden, Leiden, The Netherlands.
Insights
Automated border detection for right ventricular (RV) size in children with congenital heart disease shows promise but requires manual corrections for accurate RV function assessment. Conventional echocardiography demonstrated better agreement with MRI than automated quantification.
Area of Science:
- Pediatric Cardiology
- Echocardiography
- Cardiac Imaging
Background:
- Accurate assessment of right ventricular (RV) size is crucial for managing pediatric congenital heart disease.
- Automated border detection (ABD) and on-line quantification (AQ) systems offer potential for rapid RV size evaluation.
Purpose of the Study:
- To evaluate the usefulness of the Acoustic Quantification (AQ) system with automated border detection (ABD) for assessing RV size in children.
- To compare AQ measurements with corrected AQ, lateral gain control (LGC) images, conventional echocardiography (echo), and magnetic resonance imaging (MRI).
Main Methods:
- The study involved 36 children with congenital heart disease.
- RV size and function were assessed using AQ, corrected AQ, LGC images, conventional echo, and MRI.
- Statistical analysis compared agreement between different echocardiographic methods and MRI.
Main Results:
- Automated border detection of the RV was feasible with the AQ system at a fixed cardiac cycle point.
- Conventional echocardiography showed better agreement with MRI RV areas compared to AQ.
- Manual corrections of AQ results were necessary for adequate RV function assessment, reducing the time-saving benefit of on-line quantification.
Conclusions:
- While automated RV border detection is possible, manual adjustments are essential for accurate RV function assessment.
- Conventional echocardiography remains the preferred method for RV size assessment when compared to MRI.
- Further refinement of automated quantification techniques may be needed to fully realize their clinical utility.
Abstract:
Rapid, accurate assessment of right ventricular (RV) size is important for the management of children with congenital heart disease. The usefulness of the Acoustic Quantification system of automated border detection (ABD) and on-line quantification (AQ) for assessment of RV size was tested in 36 children. AQ data were compared to "corrected AQ" measurements (after correction for cavity areas erroneously included in the region of interest) required for AQ. Furthermore, the influence of necessary changes to gain settings was tested in "lateral gain control" (LGC) images obtained by removal of ABD overlays. All results were compared to conventional echocardiography (echo), and agreement with magnetic resonance imaging (MRI) RV areas was assessed. Systematic differences (+/-) limits of agreement with MRI (transverse plane) for conventional echo and AQ (apical four-chamber view) were as follows: end-diastolic -0.8 +/- 3.8 (conventional echo) versus -1.7 +/- 4.6 (AQ) cm2/m2 (p < 0.001); end-systolic -1.3 +/- 3.2 versus -4.9 +/- 5.8 (AQ) cm2/m2 (p < 0.001); fractional area change 7.8 +/- 17.0% versus 26.9 +/- 31.4% (AQ) (p < 0.001). Differences between conventional echo, LGC, and corrected AQ areas were not statistically significant. The best agreement between MRI and echocardiography was with conventional echo. We conclude that automated border detection of the RV can be performed successfully with the AQ system at a fixed point in the cardiac cycle. For adequate assessment of RV function manual corrections of online AQ results are still required, which results in an important reduction of the time gain of on-line quantification.