Accuracy of Left Ventricular Cavity Volume and Ejection Fraction for Conventional Estimation Methods and 3D Surface Fitting

Background While left ventricular cavity volume (LVV) and ejection fraction (LVEF) are used routinely for clinical decision‐making, the errors in LVV and LVEF estimates in the clinic have yet to be rigorously quantified and are perhaps underappreciated. Methods and Results The goal of this study was...

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Main Author: Walter G. O'Dell
Format: Article
Language:English
Published: Wiley 2019-03-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Subjects:
Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.118.009124
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author Walter G. O'Dell
author_facet Walter G. O'Dell
author_sort Walter G. O'Dell
collection DOAJ
description Background While left ventricular cavity volume (LVV) and ejection fraction (LVEF) are used routinely for clinical decision‐making, the errors in LVV and LVEF estimates in the clinic have yet to be rigorously quantified and are perhaps underappreciated. Methods and Results The goal of this study was to quantify the accuracy and precision of several common geometric‐model‐based methods for estimating LVV and LVEF using a highly sampled, high‐resolution magnetic resonance imaging data set and an independent ground truth. The effect on LVV and LVEF accuracy of slice number and orientation was also studied. When using the common geometric assumptions and limited short‐ and/or long‐axis views, the expected LVEF measurement uncertainty can be as high as 49%. The composite midpoint rule applied to a stack of short‐axis slices can achieve LVEF error <3% and LVV error of ≈10%, but in the clinic an additional ≈8% uncertainty is expected. An analogous approach applied to a series of radially prescribed long‐axis slices can achieve higher LVEF accuracy, up to 3.9% with 12 slices, and more reliable LVV measurements than methods based solely on short‐axis images. Using a mathematical 3‐dimensional surface model that incorporates anatomic information from multiple views achieves superior accuracy, with LVEF error <4% and LVV error <2.5% when using 6 slices in each short‐ and long‐axis view. Conclusions Combining anatomical information from multiple views into a conformal 3‐dimensional surface model greatly reduces errors in LVV and LVEF estimates, with potential clinical benefit via improved early detection of cardiac disease.
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spelling doaj.art-24d7bc4d002641d2b12ee6bf9ad4243b2022-12-22T02:38:40ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802019-03-018610.1161/JAHA.118.009124Accuracy of Left Ventricular Cavity Volume and Ejection Fraction for Conventional Estimation Methods and 3D Surface FittingWalter G. O'Dell0Department of Radiation Oncology University of Florida College of Medicine Gainesville FLBackground While left ventricular cavity volume (LVV) and ejection fraction (LVEF) are used routinely for clinical decision‐making, the errors in LVV and LVEF estimates in the clinic have yet to be rigorously quantified and are perhaps underappreciated. Methods and Results The goal of this study was to quantify the accuracy and precision of several common geometric‐model‐based methods for estimating LVV and LVEF using a highly sampled, high‐resolution magnetic resonance imaging data set and an independent ground truth. The effect on LVV and LVEF accuracy of slice number and orientation was also studied. When using the common geometric assumptions and limited short‐ and/or long‐axis views, the expected LVEF measurement uncertainty can be as high as 49%. The composite midpoint rule applied to a stack of short‐axis slices can achieve LVEF error <3% and LVV error of ≈10%, but in the clinic an additional ≈8% uncertainty is expected. An analogous approach applied to a series of radially prescribed long‐axis slices can achieve higher LVEF accuracy, up to 3.9% with 12 slices, and more reliable LVV measurements than methods based solely on short‐axis images. Using a mathematical 3‐dimensional surface model that incorporates anatomic information from multiple views achieves superior accuracy, with LVEF error <4% and LVV error <2.5% when using 6 slices in each short‐ and long‐axis view. Conclusions Combining anatomical information from multiple views into a conformal 3‐dimensional surface model greatly reduces errors in LVV and LVEF estimates, with potential clinical benefit via improved early detection of cardiac disease.https://www.ahajournals.org/doi/10.1161/JAHA.118.009124cardiac magnetic resonance imagingleft ventricle geometryleft ventricular ejection fractionleft ventricular functionmodeling
spellingShingle Walter G. O'Dell
Accuracy of Left Ventricular Cavity Volume and Ejection Fraction for Conventional Estimation Methods and 3D Surface Fitting
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
cardiac magnetic resonance imaging
left ventricle geometry
left ventricular ejection fraction
left ventricular function
modeling
title Accuracy of Left Ventricular Cavity Volume and Ejection Fraction for Conventional Estimation Methods and 3D Surface Fitting
title_full Accuracy of Left Ventricular Cavity Volume and Ejection Fraction for Conventional Estimation Methods and 3D Surface Fitting
title_fullStr Accuracy of Left Ventricular Cavity Volume and Ejection Fraction for Conventional Estimation Methods and 3D Surface Fitting
title_full_unstemmed Accuracy of Left Ventricular Cavity Volume and Ejection Fraction for Conventional Estimation Methods and 3D Surface Fitting
title_short Accuracy of Left Ventricular Cavity Volume and Ejection Fraction for Conventional Estimation Methods and 3D Surface Fitting
title_sort accuracy of left ventricular cavity volume and ejection fraction for conventional estimation methods and 3d surface fitting
topic cardiac magnetic resonance imaging
left ventricle geometry
left ventricular ejection fraction
left ventricular function
modeling
url https://www.ahajournals.org/doi/10.1161/JAHA.118.009124
work_keys_str_mv AT waltergodell accuracyofleftventricularcavityvolumeandejectionfractionforconventionalestimationmethodsand3dsurfacefitting