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Quantification of left ventricular volume and global function using a fast automated segmentation tool: validation in a clinical setting

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Abstract

Real-time 3D echocardiography (RT3DE) has already been shown to be an accurate tool for left ventricular (LV) volume assessment. However, LV border detection in RT3DE remains a time-consuming task jeopardizing the application of this modality in routine practice. We have recently developed a 3D automated segmentation framework (BEAS) able to capture the LV morphology in real-time. The goal of this study was to assess the accuracy of this approach in extracting volumetric parameters in a clinical setting. 24 RT3DE exams were acquired in a group of healthy volunteers (# = 5) and diseased patients (# = 19), with LV volume/function within a range typically measured in a clinical setting. End-diastolic and end-systolic volumes (EDV, ESV) were manually contoured by 3 expert sonographers from which the stroke volume and ejection fraction (SV, EF) were calculated. The values extracted with BEAS were compared to the average of the 3 experts measurements using correlation and Bland–Altman statistics. Linear regression analysis showed a strong correlation between the automated algorithm and the reference values (R = 0.963, 0.947, 0.944 and 0.853 for EDV, ESV, SV and EF respectively). Bland–Altman analysis revealed a bias (limits of agreement) of 2.59 (−25.39, 30.57) ml, −2.11 (−24.91, 20.69) ml, 4.70 (12.93, 22.34) ml and 3.45 (−8.96, 15.87) %, for EDV, ESV, SV and EF respectively. Total analysis time using BEAS was 30.7 ± 7.5 s. BEAS allows for a fast and accurate quantification of 3D cardiac volumes and global function with minimal user input. It may therefore contribute to the integration of 3D echocardiography in routine clinical practice.

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Acknowledgments

This work was supported by FCT, Portuguese Ministry of Science, Technology and Higher Education, under Grant SFRH/BD/62230/2009, by the Rhône-Alpes region, through Explora’Doc and Accueil’Doc scholarships, and by the Research Foundation-Flanders (Belgium, FWO-Vlaanderen), under the grant G.0693.09. The authors would also like to express their gratitude to the three experts providing the manual segmentations used to extract the reference LV volumetric indices used in the present manuscript, namely Helene Houle, Sharleen Marshall and Agnes Tsai.

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Authors and Affiliations

  1. Laboratory on Cardiovascular Imaging & Dynamics, Department of Cardiovascular Sciences, KU Leuven, Herestraat 49, bus 7003, 3000, Leuven, Belgium

    Daniel Barbosa, Brecht Heyde & Jan D’hooge

  2. Université de Lyon, CREATIS, CNRS UMR5220, Inserm U1044, INSA-Lyon, Université Lyon 1, Lyon, France

    Daniel Barbosa, Thomas Dietenbeck, Denis Friboulet & Olivier Bernard

  3. Siemens Ultrasound, Mountain View, CA, USA

    Helene Houle

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  1. Daniel Barbosa
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  2. Brecht Heyde
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  7. Jan D’hooge
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Correspondence to Daniel Barbosa.

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Barbosa, D., Heyde, B., Dietenbeck, T. et al. Quantification of left ventricular volume and global function using a fast automated segmentation tool: validation in a clinical setting. Int J Cardiovasc Imaging 29, 309–316 (2013). https://doi.org/10.1007/s10554-012-0103-8

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  • DOI: https://doi.org/10.1007/s10554-012-0103-8

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