Operator Induced Variability in Left Ventricular Measurements with Cardiovascular Magnetic Resonance is Improved After Training

Karamitsos, Theodoros D.; Hudsmith, Lucy; Selvanayagam, Joseph B.; Neubauer, Stefan; Francis, Jane M

doi:10.1080/10976640701545073

Cited by 110 publications

(97 citation statements)

References 24 publications

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“…22 The BOLD analysis has been previously published. 18 Briefly, myocardial signal intensity was measured after manually tracing the endocardial and epicardial contours using QMass version 6.2.3 software (Medis Medical Quantification Software).…”

Section: Cmr Data Analysismentioning

confidence: 99%

Patients With Syndrome X Have Normal Transmural Myocardial Perfusion and Oxygenation

Karamitsos

Arnold

Pegg

et al. 2012

Circ: Cardiovascular Imaging

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Background-The pathophysiology of chest pain in patients with cardiac syndrome X remains controversial. Advances in perfusion imaging with cardiovascular magnetic resonance (CMR) now enable absolute quantification of regional myocardial blood flow (MBF). Furthermore, blood oxygen level-dependent (BOLD) or oxygenation-sensitive CMR provides the unprecedented capability to assess regional myocardial oxygenation. We hypothesized that the combined assessment of regional perfusion and oxygenation with CMR could clarify whether patients with syndrome X show evidence of myocardial ischemia (reduced perfusion and oxygenation) during vasodilator stress compared with normal volunteers. Methods and Results-Eighteen patients with syndrome X (chest pain, abnormal exercise treadmill test, normal coronary angiogram without other causes of microvascular dysfunction) and 14 controls underwent CMR scanning at 3 T. Myocardial function, scar, perfusion (2-3 short-axis slices), and oxygenation were assessed. Absolute MBF was measured during adenosine stress (140 g/kg per minute) and at rest by model-independent deconvolution. For oxygenation, using a T2-prepared BOLD sequence, signal intensity was measured at adenosine stress and rest in the slice matched to the midventricular slice of the perfusion scan. There were no significant differences in MBF at stress (

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Section: Cmr Data Analysismentioning

confidence: 99%

Patients With Syndrome X Have Normal Transmural Myocardial Perfusion and Oxygenation

Karamitsos

Arnold

Pegg

et al. 2012

Circ: Cardiovascular Imaging

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“…This observed deterioration of the interobserver agreement is most likely related to the fact that no precise rules for adjusting the contours were predefined and that the observers were not specially trained in the tracing of plaque contours. Previous work has shown that training and adherence to predefined rules substantially improves the interobserver agreement of data analysis based on contour tracing [15,16]. Previous studies have evaluated the reproducibility of plaque quantification using the currently analyzed software [3,9,17].…”

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confidence: 99%

Accuracy of Coronary Plaque Detection and Assessment of Interobserver Agreement for Plaque Quantification Using Automatic Coronary Plaque Analysis Software on Coronary CT Angiography

Laqmani

Klink

Quitzke

et al. 2016

Fortschr Röntgenstr

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Purpose: To evaluate the accuracy of automatic plaque detection and the interobserver agreement of automatic versus manually adjusted quantification of coronary plaques on coronary CT angiography (cCTA) using commercially available software. Materials and Methods: 10 cCTA datasets were evaluated using plaque software. First, the automatically detected plaques were verified. Second, two observers independently performed plaque quantification without revising the automatically constructed plaque contours (automatic approach). Then, each observer adjusted the plaque contours according to plaque delineation (adjusted approach). The interobserver agreement of both approaches was analyzed. Results: 32 of 114 automatically identified findings were true-positive plaques, while 82 (72?%) were false-positive. 20 of 52 plaques (38?%) were missed by the software (false-negative). The automatic approach provided good interobserver agreement with relative differences of 0.9???16.0?% for plaque area and ?3.3???33.8?% for plaque volume. Both observers independently adjusted all contours because they did not represent the plaque delineation. Interobserver agreement decreased for the adjusted approach with relative differences of 25.0???24.8?% for plaque area and 20.0???40.4?% for plaque volume. Conclusion: The automatic plaque analysis software is of limited value due to high numbers of false-positive and false-negative plaque findings. The automatic approach was reproducible but it necessitated adjustment of all constructed plaque contours resulting in deterioration of the interobserver agreement. Key points: ??Automatic plaque detection is limited due to high false-positive and false-negative findings. ??Automatic plaque quantification was reproducible in the few accurately detected plaques. ??The automatically constructed contours did not represent the plaque delineation. ??Both observers independently adjusted the plaque contours. ??Manual adjustment of plaque contours reduced the interobserver agreement. Citation Format: ??Laqmani A, Klink T, Quitzke M et?al. Accuracy of Coronary Plaque Detection and Assessment of Interobserver Agreement for Plaque Quantification Using Automatic Coronary Plaque Analysis Software on Coronary CT Angiography. Fortschr R?ntgenstr 2016; 188: 933???939

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“…2,3,5 Cardiovascular magnetic resonance allows accurate, noninvasive assessment of left ventricular structure and function in humans. 6 Computational atlas formation has also introduced the possibility of capturing 3-dimensional geometric variation within populations to explore risk factor influences. 7,8 We used these techniques to reveal for the first time the impact of preterm birth on left ventricular structure and function in humans.…”

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confidence: 99%

Preterm Heart in Adult Life

et al. 2013

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Background— Preterm birth leads to an early switch from fetal to postnatal circulation before completion of left ventricular in utero development. In animal studies, this results in an adversely remodeled left ventricle. We determined whether preterm birth is associated with a distinct left ventricular structure and function in humans. Methods and Results— A total of 234 individuals 20 to 39 years of age underwent cardiovascular magnetic resonance. One hundred two had been followed prospectively since preterm birth (gestational age=30.3±2.5 week; birth weight=1.3±0.3 kg), and 132 were born at term to uncomplicated pregnancies. Longitudinal and short-axis cine images were used to quantify left ventricular mass, 3-dimensional geometric variation by creation of a unique computational cardiac atlas, and myocardial function. We then determined whether perinatal factors modify these left ventricular parameters. Individuals born preterm had increased left ventricular mass (66.5±10.9 versus 55.4±11.4 g/m 2 ; P <0.001) with greater prematurity associated with greater mass ( r = −0.22, P =0.03). Preterm-born individuals had short left ventricles with small internal diameters and a displaced apex. Ejection fraction was preserved ( P >0.99), but both longitudinal systolic (peak strain, strain rate, and velocity, P <0.001) and diastolic (peak strain rate and velocity, P <0.001) function and rotational (apical and basal peak systolic rotation rate, P =0.05 and P =0.006; net twist angle, P =0.02) movement were significantly reduced. A diagnosis of preeclampsia during the pregnancy was associated with further reductions in longitudinal peak systolic strain in the offspring ( P =0.02, n=29). Conclusions— Individuals born preterm have increased left ventricular mass in adult life. Furthermore, they exhibit a unique 3-dimensional left ventricular geometry and significant reductions in systolic and diastolic functional parameters. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01487824.

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Operator Induced Variability in Left Ventricular Measurements with Cardiovascular Magnetic Resonance is Improved After Training

Abstract: An intensive two month training period significantly improved the accuracy of LV functional measurements. Adequate training of new CMR operators is of paramount importance in our aim to maintain the accuracy and high reproducibility of CMR in LV function analysis.

Cited by 110 publications

References 24 publications

Patients With Syndrome X Have Normal Transmural Myocardial Perfusion and Oxygenation

Patients With Syndrome X Have Normal Transmural Myocardial Perfusion and Oxygenation

Accuracy of Coronary Plaque Detection and Assessment of Interobserver Agreement for Plaque Quantification Using Automatic Coronary Plaque Analysis Software on Coronary CT Angiography

Preterm Heart in Adult Life

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