Knowledge-based 3D reconstruction of the right ventricle: comparison with cardiac magnetic resonance in adults with congenital heart disease

Abstract

AimAssessment of right ventricular (RV) function is a challenge, especially in patients with congenital heart disease (CHD). The aim of the present study is to assess whether knowledge-based RV reconstruction, used in the everyday practice of an echo-lab for adult CHD in a tertiary referral center, is accurate when compared to cardiac magnetic resonance (CMR) examination.Subjects and methodsAdult patients who would undergo CMR for assessment of the RV were asked to undergo an echo of the heart for further knowledge-based reconstruction (KBR). Echocardiographic images were acquired in standard views using a predefined imaging protocol. RV volumes and ejection fraction (EF) calculated using knowledge-based technology were compared with the CMR data of the same patient.ResultsNineteen consecutive patients with congenital right heart disease were studied. Median age of the patients was 28 years (range 46 years). Reconstruction was possible in 16 out of 19 patients (85%). RV volumes assessed with this new method were smaller than with CMR. Indexed end diastolic volumes were 114±17 ml vs 121±19 ml, P<0.05 and EFs were 45±8% vs 47±9%, P<0.05 respectively. The correlation between the methods was good with an intraclass correlation of 0.84 for EDV and 0.89 for EF, P value <0.001 in both cases.ConclusionKBR enables reliable measurement of RVs in patients with CHDs and can be used in clinical practice for analysis of volumes and EFs.

Two‐dimensional knowledge‐based volumetric reconstruction of the right ventricle documents short‐term improvement in pulmonary hypertension

“…4 Also, parameters of systolic function assessed with 2D echocardiography showed only moderate correlation in several studies. 5,13 Feasibility of this method was also demonstrated in other studies, [14][15][16] and it is licensed for clinical use in the United Kingdom. However, CMR is costly, resource intensive and not widely available in low-income countries, which makes it less suitable for serial short-term follow-up.…”

“…12 We and others have compared 2D echocardiography knowledgebased reconstruction (2DKBR) of the right ventricle to CMR for volumetric quantification in pulmonary hypertension demonstrating good inter-and intra-observer reproducibility. 5,13 Feasibility of this method was also demonstrated in other studies, [14][15][16] and it is licensed for clinical use in the United Kingdom.…”

Impact of Isolated Tricuspid Valve Repair on Right Ventricular Remodelling in an Adult Congenital Heart Disease Population

“…In contrast, Cardiac Magnetic Resonance and the improved 3D echocardiographic imaging offer better evaluation of the right chambers of the heart (19–21). For these reasons, ACHD should be referred to specific centres in which adequate imaging and better understanding of the pathology can improve assessment and optimise surgical timing when appropriate.…”

Artificial Intelligence in Cardiac Imaging With Statistical Atlases of Cardiac Anatomy

“…Sheehan et al ( 39 ) developed a method for patient customization using a linear combination of database templates. This knowledge-based reconstruction method has shown accurate and rapid analysis of right ventricular shapes and volumes in patients with tetralogy of Fallot ( 39 ), dextro-transposition of the great arteries ( 40 ), and other types of congenital heart disease ( 41 ). A more dilated and spherical right ventricle was found in patients with transposition of the great arteries after atrial switch, with regional reduction in function at the base ( 42 , 43 ).…”