Top

BMC Medical Imaging

Published in:

Open Access 01-12-2014 | Technical advance

Automatic measurement of aortic annulus diameter in 3-dimensional Transoesophageal echocardiography

Authors: Jørn Bersvendsen, Jan O Beitnes, Stig Urheim, Svend Aakhus, Eigil Samset

Published in: BMC Medical Imaging | Issue 1/2014

Abstract

Background

Transcatheter aortic valve implantation involves percutaneously implanting a biomechanical aortic valve to treat severe aortic stenosis. In order to select a proper device, precise sizing of the aortic valve annulus must be completed.

Methods

In this paper, we describe a fully automatic segmentation method to measure the aortic annulus diameter in patients with aortic calcification, operating on 3-dimensional transesophageal echocardiographic images. The method is based on state estimation of a subdivision surface representation of the left ventricular outflow tract and aortic root. The state estimation is solved by an extended Kalman filter driven by edge detections normal to the subdivision surface.

Results

The method was validated on echocardiographic recordings of 16 patients. Comparison against two manual measurements showed agreements (mean ±SD) of -0.3±1.6 and -0.2±2.3 mm for perimeter-derived diameters, compared to an interobserver agreement of -0.1±2.1 mm.

Conclusions

With this study, we demonstrated the feasibility of an efficient and fully automatic measurement of the aortic annulus in patients with aortic disease. The algorithm robustly measured the aortic annulus diameter, providing measurements indistinguishable from those done by cardiologists.

Available only for authorised users

Zamorano JL, Badano LP, Bruce C, Chan K-L, Gonçalves A, Hahn RT, Keane MG, La Canna G, Monaghan MJ, Nihoyannopoulos P, Silvestry FE, Vanoverschelde J-L, Gillam LD, Vahanian A, Di Bello V, Buck T: EAE/ASE recommendations for the use of echocardiography in new transcatheter interventions for valvular heart disease. Eur J Echocardiogr : J Working Group Echocardiogr Eur Soc Cardiol. 2011, 12 (8): 557-584. 10.1093/ejechocard/jer086. doi:10.1093/ejechocard/jer086,CrossRef

Jilaihawi H, Kashif M, Fontana G, Furugen A, Shiota T, Friede G, Makhija R, Doctor N, Leon MB, Makkar RR: Cross-sectional computed tomographic assessment improves accuracy of aortic annular sizing for transcatheter aortic valve replacement and reduces the incidence of paravalvular aortic regurgitation. J Am Coll Cardiol. 2012, 59 (14): 1275-1286. 10.1016/j.jacc.2011.11.045. doi:10.1016/j.jacc.2011.11.045,CrossRefPubMed

Ng ACT, Delgado V, van der Kley F, Shanks M, van de Veire NRL, Bertini M, Nucifora G, van Bommel RJ, Tops LF, de Weger A, Tavilla G, de Roos A, Kroft LJ, Leung DY, Schuijf J, Schalij MJ, Bax JJ: Comparison of aortic root dimensions and geometries before and after transcatheter aortic valve implantation by 2- and 3-dimensional transesophageal echocardiography and multislice computed tomography. Circ Cardiovasc Imaging. 2010, 3 (1): 94-102. 10.1161/CIRCIMAGING.109.885152. doi:10.1161/CIRCIMAGING.109.885152,CrossRefPubMed

Altiok E, Koos R, Schröder J, Brehmer K, Hamada S, Becker M, Mahnken AH, Almalla M, Dohmen G, Autschbach R, Marx N, Hoffmann R: Comparison of two-dimensional and three-dimensional imaging techniques for measurement of aortic annulus diameters before transcatheter aortic valve implantation. Heart (British Cardiac Soc). 2011, 97 (19): 1578-1584. 10.1136/hrt.2011.223974. doi:10.1136/hrt.2011.223974,CrossRef

Muraru D, Badano LP, Vannan M, Iliceto S: Assessment of aortic valve complex by three-dimensional echocardiography: a framework for its effective application in clinical practice. Eur Heart J Cardiovascular Imaging. 2012, 13 (7): 541-555. 10.1093/ehjci/jes075. doi:10.1093/ehjci/jes075,CrossRef

Orderud F: A Framework for real-time left ventricular tracking in 3D+T echocardiography, using nonlinear deformable contours and kalman filter based tracking. Computers in Cardiology, 2006. 2006, [http://ieeexplore.ieee.org/xpl/articleDetails.jsp?arnumber=4511804],

Orderud F, Rabben SI: Real-time 3d segmentation of the left ventricle using deformable subdivision surfaces. Computer Vision and Pattern Recognition, 2008.CVPR 2008. IEEE Conference On. 2008, 1-8. doi:10.1109/CVPR.2008.4587442,CrossRef

Hamdan A, Guetta V, Konen E, Goitein O, Segev A, Raanani E, Spiegelstein D, Hay I, Di Segni E, Eldar M, Schwammenthal E: Deformation dynamics and mechanical properties of the aortic annulus by 4-dimensional computed tomography: insights into the functional anatomy of the aortic valve complex and implications for transcatheter aortic valve therapy. J Am Coll Cardiol. 2012, 59 (2): 119-27. 10.1016/j.jacc.2011.09.045. doi:10.1016/j.jacc.2011.09.045,CrossRefPubMed

Calleja A, Thavendiranathan P, Ionasec RI, Houle H, Liu S, Voigt I, Sai Sudhakar C, Crestanello J, Ryan T, Vannan MA: Automated quantitative 3-d modeling of the aortic valve and root by 3-d transesophageal echocardiography in normals, aortic regurgitation and, aortic stenosis: comparison to computed tomography in normals and clinical implications. Circ: Cardiovasc Imaging. 2012, doi:10.1161/CIRCIMAGING.112.976993,

10.

Ionasec RI, Voigt I, Georgescu B, Wang Y, Houle H, Vega-Higuera F, Navab N, Comaniciu D: Patient-specific modeling and quantification of the aortic and mitral valves from 4-d cardiac ct and tee. Med Imaging IEEE Trans on. 2010, 29 (9): 1636-1651. doi:10.1109/TMI.2010.2048756,CrossRef

The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2342/14/31/prepub

Title: Automatic measurement of aortic annulus diameter in 3-dimensional Transoesophageal echocardiography
Authors: Jørn Bersvendsen
Jan O Beitnes
Stig Urheim
Svend Aakhus
Eigil Samset
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: BMC Medical Imaging / Issue 1/2014
Electronic ISSN: 1471-2342
DOI: https://doi.org/10.1186/1471-2342-14-31

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Automatic measurement of aortic annulus diameter in 3-dimensional Transoesophageal echocardiography

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2014

Breast cancer detection using sonography in women with mammographically dense breasts

The more you look, the more you find: challenging results on FDG-PET CT in a patient with neurofibromatosis type I

Fractal dimension analysis of malignant and benign endobronchial ultrasound nodes

Area of ischemia assessed by physicians and software packages from myocardial perfusion scintigrams

Interactive neonatal gastrointestinal magnetic resonance imaging using fruit juice as an oral contrast media

Magnetic resonance imaging of penile paraffinoma: case report