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DOI: 10.1055/s-0029-1245729
© Georg Thieme Verlag KG Stuttgart · New York
Computer-Based Automated Left Atrium Segmentation and Volumetry from ECG-Gated Coronary CT Angiography Data: Comparison with Manual Slice Segmentation and Ultrasound Planimetric Methods
Computergestützte automatische Segmentierung und Volumetrie des linken Vorhofs in Herz-CT-Datensätzen – ein Vergleich mit manueller Schichtsegmentierung und planimetrischen UltraschallmethodenPublikationsverlauf
received: 9.6.2010
accepted: 24.8.2010
Publikationsdatum:
11. Oktober 2010 (online)

Zusammenfassung
Ziel: Die Dilatation des linken Vorhofs ist ein bekannter Risikofaktor z. B. für das Auftreten von Rhythmusstörungen mit konsekutiven kardiovaskulären oder zerebrovaskulären Ereignissen. In dieser Arbeit wurde die Leistung einer Prototypen-Software zur automatischen Segmentierung und Volumetrie des linken Vorhofs aus Koronar-CT-Angiografie-Datensätzen evaluiert. Material und Methoden: In 34 Funktionsdatensätzen aus retrospektiv EKG-synchronisierten Koronar-CT-Angiografien (64-Zeilen-Gerät) wurde retrospektiv das endsystolische (LAVsys) und enddiastolische (LAVdia) Volumen des linken Vorhofs vollautomatisch durch eine Prototypen-Software kalkuliert. Als Referenzstandard dienten Werte, die 2 erfahrene unabhängige Radiologen mittels manueller Schichtsegmentierung bestimmt hatten. Weiterhin wurden 2 gängige Methoden der Echokardiografie („area length” und „prolate ellipse”) von 2 unabhängigen Untersuchern verglichen, nachdem die entsprechenden Ultraschallschnittebenen in den CT-Datensätze eingestellt wurden. Die benötigten Messzeiten für alle Messmethoden wurden verglichen. Ergebnisse: Die Ergebnisse der Software stimmten hervorragend mit den Messungen der Radiologen überein (r = 0,97 – 0,99; p < 0,001), welche untereinander ebenfalls eine hervorragende Übereinstimmung zeigten (r = 0,99; p < 0,001). Die Ultraschallmethoden zeigten deutlich größere Abweichungen (r = 0,72 – 0,86) mit nur moderater Übereinstimmung zwischen den Untersuchern (r = 0,51 – 0,79). Der durchschnittliche Zeitaufwand war mit der Software signifikant geringer (267 ± 28 s; p < 0,001) als mit Ultraschallmethode (431 ± 68 s) und manueller Schichtsegmentierung (567 ± 91 s). Schlussfolgerung: Die Prototypen-Software zeigt eine hervorragende Übereinstimmung mit dem Referenzstandard bei geringstem Zeitaufwand. Dies ermöglicht die routinemäßige Bestimmung der LA-Größe aus Herz-CT-Daten und somit eine mögliche Risikostratifizierung.
Abstract
Purpose: Enlargement of the left atrium is a risk factor for cardiovascular or cerebrovascular events. We evaluated the performance of prototype software for fully automated segmentation and volumetry of the left atrium. Materials and Methods: In 34 retrospectively ECG-gated coronary CT angiography scans, the end-systolic (LAVsys) and end-diastolic (LAVdia) volume of the left atrium was calculated fully automatically by prototype software. Manual slice segmentation by two independent experienced radiologists served as the reference standard. Furthermore, two independent observers calculated the LAV utilizing two ultrasound planimetric methods (”area length” and ”prolate ellipse”) on CTA images. Measurement periods were compared for all methods. Results: The left atrial volumes calculated with the prototype software were in excellent agreement with the results from manual slice segmentation (r = 0.97 – 0.99; p < 0.001; Bland-Altman) with excellent interobserver agreement between both radiologists (r = 0.99; p < 0.001). Ultrasound planimetric methods clearly showed a higher variation (r = 0.72 – 0.86) with moderate interobserver agreement (r = 0.51 – 0.79). The measurement period was significantly lower with the software (267 ± 28 sec; p < 0.001) than with ultrasound methods (431 ± 68 sec) or manual slice segmentation (567 ± 91 sec). Conclusion: The prototype software showed excellent agreement with manual slice segmentation with the least time consumption. This will facilitate the routine assessment of the LA volume from coronary CTA data and therefore risk stratification.
Key words
cardiac - heart - CT - diagnostic radiology - segmentation - technology assessment
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Dr. Ralf W. Bauer
Institut für Diagnostische und Interventionelle Radiologie, Klinikum der Goethe-Universität
Haus 23C UG
60590 Frankfurt
Germany
Telefon: ++ 49/69/63 01 72 77
Fax: ++ 49/69/63 01 72 58
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