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Left ventricular volumes and the importance of contouring the basal slice

Session Poster session 2

Speaker Bostjan Berlot

Event : EuroCMR 2019

  • Topic : imaging
  • Sub-topic : Cardiac Magnetic Resonance: Dimensions, Volumes and Mass
  • Session type : Poster Session

Authors : B Berlot (Bristol,GB), I Harries (Bristol,GB), G Biglino (Bristol,GB), C Bucciarelli-Ducci (Bristol,GB)

Authors:
B Berlot1 , I Harries1 , G Biglino1 , C Bucciarelli-Ducci1 , 1Bristol Heart Institute - Bristol - United Kingdom of Great Britain & Northern Ireland ,

Citation:
European Heart Journal - Cardiovascular Imaging ( 2019 ) 20 ( Supplement 2 ), ii330

Introduction

Contouring the basal slice of the left ventricle (LV) is subjective and may be a source of interobserver variability. This study investigated the reproducibility of three different methods:  the SCMR Taskforce recommendation / UK Biobank (Method A), anatomical (Method B) and another method commonly used in clinical practice (Method C)

Methods

After agreeing on end-diastolic and end-systolic phases, two experienced researchers contoured 50 subjects with dilated cardiomyopathy (DCM) and 50 normal subjects using each method (Figure). Interobserver reproducibility for ejection fraction (EF), end-diastolic (EDV) and end systolic volume (ESV) were determined using the percent difference (%diff) and intraclass correlation coefficients (ICC). 

Results

Interobserver reproducibility of all methods was good (ICC=0.819). The best reproducibility was achieved using Method B when calculating EDV in DCM subjects (2.2%), and the worst using Method C (4.5 %).  All methods calculated similar ejection fraction, except Method A vs Method B in normal subjects (64±6 vs 62±6%, p=0.001).  Compared to Method A, all volumes were significantly smaller with Method C, and ESV in normal subjects was significantly bigger with Method B (Table). 

Conclusion

Interobserver reproducibility was good with all 3 methods and different basal slice contouring methodologies largely produced similar ejection fractions, despite small but significant differences in volumes. This suggests that methods are not interchangeable and the same method should be used for follow-up imaging.

Method A

Method B

Method C

Mean±SD

ICC

% Diff±SD

Mean±SD

ICC

% Diff±SD

Mean±SD

ICC

% Diff±SD

N = 50

Subjects with normal left ventricular size and ejection fraction

EDV (ml)

140±24

0.965

2.8±3.5

139±23

0.978

2.5±2.2

122±22£

0.936

3.5±5.1

ESV (ml)

51±12

0.902

7.0±8.5

53±12£

0.935

5.6±5.6

44±11£

0.954

3.5±6.1

EF (%)

64±6

0.823

3.9±4.3

62±6£

0.819

4.2±3.7

64±6

0.882

3.0±3.4

N = 50

Subjects with dilated ventricles and impaired ejection fraction

EDV(ml)

258±96

0.994

3.5±4.5

256±97

0.998

2.2±1.9*

232±94£

0.989

4.5±5.6§

ESV(ml)

186±101

0.995

3.6±4.8

186±100

0.998

2.6±2.9

168±97£

0.993

3.6±5.2

EF (%)

31±13

0.945

12.7±14.0

31±13

0.950

10.6±13.1

32±14

0.948

10.9±16.5

EDV = end-diastolic volume, ESV = end-systolic volume, EF = ejection fraction, %Diff = percentage difference, £The value was significantly different compared to Method A (p < 0.05), *Interobserver reproducibility had lowest % differences (p < 0.05), § Interobserver reproducibility had highest % differences (p < 0.05)

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