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Comparative Study
. 2018 Feb;34(2):281-291.
doi: 10.1007/s10554-017-1225-9. Epub 2017 Aug 23.

Fully-automated left ventricular mass and volume MRI analysis in the UK Biobank population cohort: evaluation of initial results

Avan Suinesiaputra  1 , Mihir M Sanghvi  2 , Nay Aung  2 , Jose Miguel Paiva  2 , Filip Zemrak  2 , Kenneth Fung  2 , Elena Lukaschuk  3 , Aaron M Lee  2 , Valentina Carapella  3 , Young Jin Kim  3 , Jane Francis  3 , Stefan K Piechnik  3 , Stefan Neubauer  3 , Andreas Greiser  4 , Marie-Pierre Jolly  5 , Carmel Hayes  4 , Alistair A Young  6 , Steffen E Petersen  2
Affiliations
Comparative Study

Fully-automated left ventricular mass and volume MRI analysis in the UK Biobank population cohort: evaluation of initial results

Avan Suinesiaputra et al. Int J Cardiovasc Imaging. 2018 Feb.

Abstract

UK Biobank, a large cohort study, plans to acquire 100,000 cardiac MRI studies by 2020. Although fully-automated left ventricular (LV) analysis was performed in the original acquisition, this was not designed for unsupervised incorporation into epidemiological studies. We sought to evaluate automated LV mass and volume (Siemens syngo InlineVF versions D13A and E11C), against manual analysis in a substantial sub-cohort of UK Biobank participants. Eight readers from two centers, trained to give consistent results, manually analyzed 4874 UK Biobank cases for LV end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF) and LV mass (LVM). Agreement between manual and InlineVF automated analyses were evaluated using Bland-Altman analysis and the intra-class correlation coefficient (ICC). Tenfold cross-validation was used to establish a linear regression calibration between manual and InlineVF results. InlineVF D13A returned results in 4423 cases, whereas InlineVF E11C returned results in 4775 cases and also reported LVM. Rapid visual assessment of the E11C results found 178 cases (3.7%) with grossly misplaced contours or landmarks. In the remaining 4597 cases, LV function showed good agreement: ESV -6.4 ± 9.0 ml, 0.853 (mean ± SD of the differences, ICC) EDV -3.0 ± 11.6 ml, 0.937; SV 3.4 ± 9.8 ml, 0.855; and EF 3.5 ± 5.1%, 0.586. Although LV mass was consistently overestimated (29.9 ± 17.0 g, 0.534) due to larger epicardial contours on all slices, linear regression could be used to correct the bias and improve accuracy. Automated InlineVF results can be used for case-control studies in UK Biobank, provided visual quality control and linear bias correction are performed. Improvements between InlineVF D13A and InlineVF E11C show the field is rapidly advancing, with further improvements expected in the near future.

Keywords: Automated analysis; UK Biobank; Ventricular function.

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Conflict of interest statement

Conflict of interest

AAY reports receiving consulting fees from Siemens Healthcare. AG, MPJ, CH are employees of Siemens Healthcare. SEP reports receiving consulting fees from Circle Cardiovascular Imaging, Inc., Calgary, Canada.

Ethical Approval

All human studies were approved by the appropriate ethics committees and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study have been omitted.

Figures

Fig. 1
Fig. 1
a InlineVF results for a typical case with good agreement for volume (<5 ml for EDV and ESV) but overestimation of mass (61 g) compared with manual analysis. b InlineVF results for a case with relatively large discrepancy between manual and inlineVF results (30 ml in EDV). Contours show errors at the base slice
Fig. 2
Fig. 2
InlineVF results for two cases classified as failure by visual inspection. a Base landmarks incorrect and LV contours cover both ventricles. b LV contours show gross errors at the base and apex
Fig. 3
Fig. 3
Bland–Atman plots for InlineVF E11C results with visual failures removed (n = 4597). Dotted lines are mean difference ± 1.96 SD
Fig. 4
Fig. 4
Linear regression plots the InlineVF E11C results with visual failures removed (n = 4597). Solid line is the linear regression; dotted line is the line of identity
See this image and copyright information in PMC

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