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. 2013 Apr 3;3(2):271-82.
doi: 10.3390/diagnostics3020271.

Quantification of Right and Left Ventricular Function in Cardiac MR Imaging: Comparison of Semiautomatic and Manual Segmentation Algorithms

Miguel Souto  1   2 , Lambert Raul Masip  3 , Miguel Couto  4 , Jorge Juan Suárez-Cuenca  5 , Amparo Martínez  6 , Pablo G Tahoces  7 , Jose Martin Carreira  8   9 , Pierre Croisille  10
Affiliations

Quantification of Right and Left Ventricular Function in Cardiac MR Imaging: Comparison of Semiautomatic and Manual Segmentation Algorithms

Miguel Souto et al. Diagnostics (Basel). .

Abstract

The purpose of this study was to evaluate the performance of a semiautomatic segmentation method for the anatomical and functional assessment of both ventricles from cardiac cine magnetic resonance (MR) examinations, reducing user interaction to a "mouse-click". Fifty-two patients with cardiovascular diseases were examined using a 1.5-T MR imaging unit. Several parameters of both ventricles, such as end-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (EF), were quantified by an experienced operator using the conventional method based on manually-defined contours, as the standard of reference; and a novel semiautomatic segmentation method based on edge detection, iterative thresholding and region growing techniques, for evaluation purposes. No statistically significant differences were found between the two measurement values obtained for each parameter (p > 0.05). Correlation to estimate right ventricular function was good (r > 0.8) and turned out to be excellent (r > 0.9) for the left ventricle (LV). Bland-Altman plots revealed acceptable limits of agreement between the two methods (95%). Our study findings indicate that the proposed technique allows a fast and accurate assessment of both ventricles. However, further improvements are needed to equal results achieved for the right ventricle (RV) using the conventional methodology.

Keywords: cardiac cine magnetic resonance imaging (MRI); ejection fraction (EF); left ventricular function; right ventricular function; segmentation.

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Figures

Figure 1
Figure 1
Cardiac magnetic resonance (MR) imaging, trueFISP cine sequence, short-axis views, manual segmentation: end-diastolic (ED; left) and end-systolic (ES; right) contours of the right ventricle (RV), at the basal, midventricular, and apical levels, in a patient with repaired Fallot’s tetralogy, showing right ventricular dilatation (end-diastolic volume index 148 mL/m2); and dysfunction (ejection fraction 32%).
Figure 2
Figure 2
Semiautomatic segmentation scheme showing, from left to right: original gray-scale image, edge detection after iterative thresholding (binary image 1), background overlapping of binary images 1 and 2 (binary image 3), and region growing steps.
Figure 3
Figure 3
From left to right: Bland-Altman plots show the agreement between semiautomatic and manual segmentation methods, for left ventricular end-diastolic volume (EDV), end-systolic volume (ESV), and ejection fraction (EF).
Figure 4
Figure 4
From left to right: Bland-Altman plots show the agreement between semiautomatic and manual segmentation methods, for right ventricular end-diastolic volume (EDV), end-systolic volume (ESV), and ejection fraction (EF).
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