Clinical evaluation of a fully automated model-based algorithm to calculate left ventricular volumes and ejection fraction using multidetector computed tomography

Abstract

Objectives: To evaluate feasibility and accuracy of a fully automatic algorithm (FAA) for calculating left ventricular volumes and ejection fraction (LVEF) from multidetector computed tomography (MDCT) studies versus a previously validated method based on Simpson's method serving as our reference standard (RS), and left ventriculography (LVG), in patients with acute chest pain (ACP).

Methods: 23 patients admitted with ACP underwent ECG-gated MDCT, as well as LVG during their hospitalization. MDCT based end-diastolic, end-systolic and stroke volumes (EDV, ESV, SV) and LVEF were calculated using the RS and the FAA.

Results: One patient was excluded after FAA failure to detect contours. In the remaining 22 patients, mean+/-SD LVEF measurements were RS 61+/-11%, FAA 59+/-11% (r = 0.91 versus RS), LVG 57+/-16% (r = 0.6 versus RS). In comparison to RS, FAA overestimated EDV by 10.1+/-8.5 ml, ESV by 7.3+/-6.4 ml and SV by 3.6+/-8.6 ml, and underestimated LVEF measurements by 2.7+/-4.6%, related to contour smoothing. LVEF by FAA was within 8% of RS for all patients except one. In contrast, LVG differed significantly from RS.

Conclusions: The evaluated FAA obtained accurate, clinically relevant results for left ventricular volumes and LVEF relative to the RS.