Skip to main content
Top
Published in: The International Journal of Cardiovascular Imaging 2/2013

01-02-2013 | Original Paper

Fully automated right ventricular volumetry from ECG-gated coronary CT angiography data: evaluation of prototype software

Authors: Thomas Lehnert, Anna Wrzesniak, Dominik Bernhardt, Hanns Ackermann, J. Matthias Kerl, Fernando Vega-Higuera, Thomas J. Vogl, Ralf W. Bauer

Published in: The International Journal of Cardiovascular Imaging | Issue 2/2013

Login to get access

Abstract

Enlargement and dysfunction of the right ventricle (RV) is a sign and outcome predictor of many cardiopulmonary diseases. Due to the complex geometry of the RV exact volumetry is cumbersome and time-consuming. We evaluated the performance of prototype software for fully automated RV segmentation and volumetry from cardiac CT data. In 50 retrospectively ECG-gated coronary CT angiography scans the endsystolic (RVVmin) and enddiastolic (RVVmax) volume of the right ventricle was calculated fully automatically by prototype software. Manual slice segmentation by two independent radiologists served as the reference standard. Measurement periods were compared for both methods. RV volumes calculated with the software were in strong agreement with the results from manual slice segmentation (Bland–Altman r = 0.95–0.98; p < 0.001; Lin’s correlation Rho = 0.87–0.96, p < 0.001) for RVVmax and RVVmin with excellent interobserver agreement between both radiologists (r = 0.97; p < 0.001). The measurement period was significantly shorter with the software (153 ± 9 s) than with manual slice segmentation (658 ± 211 s). The prototype software demonstrated very good performance in comparison to the reference standard. It promises robust RV volume results and minimizes postprocessing time.
Literature
1.
go back to reference Haddad F, Doyle R, Murphy DJ, Hunt SA (2008) Right ventricular function in cardiovascular disease, part II: pathophysiology, clinical importance, and management of right ventricular failure. Circulation 117:1717–1731PubMedCrossRef Haddad F, Doyle R, Murphy DJ, Hunt SA (2008) Right ventricular function in cardiovascular disease, part II: pathophysiology, clinical importance, and management of right ventricular failure. Circulation 117:1717–1731PubMedCrossRef
2.
go back to reference Haddad F, Hunt SA, Rosenthal DN, Murphy DJ (2008) Right ventricular function in cardiovascular disease, part I: anatomy, physiology, aging, and functional assessment of the right ventricle. Circulation 117:1436–1448PubMedCrossRef Haddad F, Hunt SA, Rosenthal DN, Murphy DJ (2008) Right ventricular function in cardiovascular disease, part I: anatomy, physiology, aging, and functional assessment of the right ventricle. Circulation 117:1436–1448PubMedCrossRef
3.
go back to reference Kerl JM, Ravenel JG, Nguyen SA et al (2008) Right heart: split-bolus injection of diluted contrast medium for visualization at coronary CT angiography. Radiology 247:356–364PubMedCrossRef Kerl JM, Ravenel JG, Nguyen SA et al (2008) Right heart: split-bolus injection of diluted contrast medium for visualization at coronary CT angiography. Radiology 247:356–364PubMedCrossRef
5.
go back to reference Takx RA, Moscariello A, Schoepf UJ et al (2011) Quantification of left and right ventricular function and myocardial mass: comparison of low-radiation dose 2nd generation dual-source CT and cardiac MRI. Eur J Radiol. doi:10.1016/j.ejrad.2011.07.001 PubMed Takx RA, Moscariello A, Schoepf UJ et al (2011) Quantification of left and right ventricular function and myocardial mass: comparison of low-radiation dose 2nd generation dual-source CT and cardiac MRI. Eur J Radiol. doi:10.​1016/​j.​ejrad.​2011.​07.​001 PubMed
6.
go back to reference Schwarz F, Ruzsics B, Schoepf UJ et al (2008) Dual-energy CT of the heart–principles and protocols. Eur J Radiol 68:423–433PubMedCrossRef Schwarz F, Ruzsics B, Schoepf UJ et al (2008) Dual-energy CT of the heart–principles and protocols. Eur J Radiol 68:423–433PubMedCrossRef
7.
go back to reference Zheng Y, Barbu A, Georgescu B, Scheuering M, Comaniciu D (2008) Four-chamber heart modeling and automatic segmentation for 3-D cardiac CT volumes using marginal space learning and steerable features. IEEE Trans Med Imaging 27:1668–1681PubMedCrossRef Zheng Y, Barbu A, Georgescu B, Scheuering M, Comaniciu D (2008) Four-chamber heart modeling and automatic segmentation for 3-D cardiac CT volumes using marginal space learning and steerable features. IEEE Trans Med Imaging 27:1668–1681PubMedCrossRef
8.
go back to reference Cook AL, Hurwitz LM, Valente AM, Herlong JR (2007) Right heart dilatation in adults: congenital causes. AJR Am J Roentgenol 189:592–601PubMedCrossRef Cook AL, Hurwitz LM, Valente AM, Herlong JR (2007) Right heart dilatation in adults: congenital causes. AJR Am J Roentgenol 189:592–601PubMedCrossRef
9.
go back to reference Di Salvo TG, Mathier M, Semigran MJ, Dec GW (1995) Preserved right ventricular ejection fraction predicts exercise capacity and survival in advanced heart failure. J Am Coll Cardiol 25:1143–1153PubMedCrossRef Di Salvo TG, Mathier M, Semigran MJ, Dec GW (1995) Preserved right ventricular ejection fraction predicts exercise capacity and survival in advanced heart failure. J Am Coll Cardiol 25:1143–1153PubMedCrossRef
10.
go back to reference Gavazzi A, Berzuini C, Campana C et al (1997) Value of right ventricular ejection fraction in predicting short-term prognosis of patients with severe chronic heart failure. J Heart Lung Transplant 16:774–785PubMed Gavazzi A, Berzuini C, Campana C et al (1997) Value of right ventricular ejection fraction in predicting short-term prognosis of patients with severe chronic heart failure. J Heart Lung Transplant 16:774–785PubMed
11.
go back to reference Ghio S, Gavazzi A, Campana C et al (2001) Independent and additive prognostic value of right ventricular systolic function and pulmonary artery pressure in patients with chronic heart failure. J Am Coll Cardiol 37:183–188PubMedCrossRef Ghio S, Gavazzi A, Campana C et al (2001) Independent and additive prognostic value of right ventricular systolic function and pulmonary artery pressure in patients with chronic heart failure. J Am Coll Cardiol 37:183–188PubMedCrossRef
12.
go back to reference Meluzin J, Spinarova L, Hude P et al (2005) Combined right ventricular systolic and diastolic dysfunction represents a strong determinant of poor prognosis in patients with symptomatic heart failure. Int J Cardiol 105:164–173PubMedCrossRef Meluzin J, Spinarova L, Hude P et al (2005) Combined right ventricular systolic and diastolic dysfunction represents a strong determinant of poor prognosis in patients with symptomatic heart failure. Int J Cardiol 105:164–173PubMedCrossRef
13.
go back to reference Owan TE, Hodge DO, Herges RM, Jacobsen SJ, Roger VL, Redfield MM (2006) Trends in prevalence and outcome of heart failure with preserved ejection fraction. N Engl J Med 355:251–259PubMedCrossRef Owan TE, Hodge DO, Herges RM, Jacobsen SJ, Roger VL, Redfield MM (2006) Trends in prevalence and outcome of heart failure with preserved ejection fraction. N Engl J Med 355:251–259PubMedCrossRef
14.
go back to reference Carter T, Ellis K (2005) Right-ventricular infarction. Crit Care Nurse 25:52–54, 56–58, 60–52 Carter T, Ellis K (2005) Right-ventricular infarction. Crit Care Nurse 25:52–54, 56–58, 60–52
15.
go back to reference Goldstein JA, Barzilai B, Rosamond TL, Eisenberg PR, Jaffe AS (1990) Determinants of hemodynamic compromise with severe right ventricular infarction. Circulation 82:359–368PubMedCrossRef Goldstein JA, Barzilai B, Rosamond TL, Eisenberg PR, Jaffe AS (1990) Determinants of hemodynamic compromise with severe right ventricular infarction. Circulation 82:359–368PubMedCrossRef
16.
go back to reference Lu MT, Cai T, Ersoy H et al (2008) Interval increase in right-left ventricular diameter ratios at CT as a predictor of 30-day mortality after acute pulmonary embolism: initial experience. Radiology 246:281–287PubMed Lu MT, Cai T, Ersoy H et al (2008) Interval increase in right-left ventricular diameter ratios at CT as a predictor of 30-day mortality after acute pulmonary embolism: initial experience. Radiology 246:281–287PubMed
17.
go back to reference Lu MT, Demehri S, Cai T et al (2012) Axial and reformatted four-chamber right ventricle-to-left ventricle diameter ratios on pulmonary CT angiography as predictors of death after acute pulmonary embolism. AJR Am J Roentgenol 198:1353–1360PubMedCrossRef Lu MT, Demehri S, Cai T et al (2012) Axial and reformatted four-chamber right ventricle-to-left ventricle diameter ratios on pulmonary CT angiography as predictors of death after acute pulmonary embolism. AJR Am J Roentgenol 198:1353–1360PubMedCrossRef
18.
go back to reference Burgess MI, Mogulkoc N, Bright-Thomas RJ, Bishop P, Egan JJ, Ray SG (2002) Comparison of echocardiographic markers of right ventricular function in determining prognosis in chronic pulmonary disease. J Am Soc Echocardiogr 15:633–639PubMedCrossRef Burgess MI, Mogulkoc N, Bright-Thomas RJ, Bishop P, Egan JJ, Ray SG (2002) Comparison of echocardiographic markers of right ventricular function in determining prognosis in chronic pulmonary disease. J Am Soc Echocardiogr 15:633–639PubMedCrossRef
19.
go back to reference Ionescu AA, Payne N, Obieta-Fresnedo I, Fraser AG, Shale DJ (2001) Subclinical right ventricular dysfunction in cystic fibrosis. A study using tissue Doppler echocardiography. Am J Respir Crit Care Med 163:1212–1218PubMed Ionescu AA, Payne N, Obieta-Fresnedo I, Fraser AG, Shale DJ (2001) Subclinical right ventricular dysfunction in cystic fibrosis. A study using tissue Doppler echocardiography. Am J Respir Crit Care Med 163:1212–1218PubMed
20.
go back to reference de Groote P, Millaire A, Foucher-Hossein C et al (1998) Right ventricular ejection fraction is an independent predictor of survival in patients with moderate heart failure. J Am Coll Cardiol 32:948–954PubMedCrossRef de Groote P, Millaire A, Foucher-Hossein C et al (1998) Right ventricular ejection fraction is an independent predictor of survival in patients with moderate heart failure. J Am Coll Cardiol 32:948–954PubMedCrossRef
21.
go back to reference Larose E, Ganz P, Reynolds HG et al (2007) Right ventricular dysfunction assessed by cardiovascular magnetic resonance imaging predicts poor prognosis late after myocardial infarction. J Am Coll Cardiol 49:855–862PubMedCrossRef Larose E, Ganz P, Reynolds HG et al (2007) Right ventricular dysfunction assessed by cardiovascular magnetic resonance imaging predicts poor prognosis late after myocardial infarction. J Am Coll Cardiol 49:855–862PubMedCrossRef
22.
go back to reference van der Bijl N, Klok FA, Huisman MV et al (2011) Measurement of right and left ventricular function by ECG-synchronized CT scanning in patients with acute pulmonary embolism: usefulness for predicting short-term outcome. Chest 140:1008–1015PubMedCrossRef van der Bijl N, Klok FA, Huisman MV et al (2011) Measurement of right and left ventricular function by ECG-synchronized CT scanning in patients with acute pulmonary embolism: usefulness for predicting short-term outcome. Chest 140:1008–1015PubMedCrossRef
23.
go back to reference Henzler T, Krissak R, Reichert M, Sueselbeck T, Schoenberg SO, Fink C (2010) Volumetric analysis of pulmonary CTA for the assessment of right ventricular dysfunction in patients with acute pulmonary embolism. Acad Radiol 17:309–315PubMedCrossRef Henzler T, Krissak R, Reichert M, Sueselbeck T, Schoenberg SO, Fink C (2010) Volumetric analysis of pulmonary CTA for the assessment of right ventricular dysfunction in patients with acute pulmonary embolism. Acad Radiol 17:309–315PubMedCrossRef
Metadata
Title
Fully automated right ventricular volumetry from ECG-gated coronary CT angiography data: evaluation of prototype software
Authors
Thomas Lehnert
Anna Wrzesniak
Dominik Bernhardt
Hanns Ackermann
J. Matthias Kerl
Fernando Vega-Higuera
Thomas J. Vogl
Ralf W. Bauer
Publication date
01-02-2013
Publisher
Springer Netherlands
Published in
The International Journal of Cardiovascular Imaging / Issue 2/2013
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-012-0109-2

Other articles of this Issue 2/2013

The International Journal of Cardiovascular Imaging 2/2013 Go to the issue