PMID- 25736308
OWN - NLM
STAT- MEDLINE
DCOM- 20160502
LR  - 20191210
IS  - 2047-2412 (Electronic)
IS  - 2047-2404 (Print)
IS  - 2047-2404 (Linking)
VI  - 16
IP  - 7
DP  - 2015 Jul
TI  - Quantification of infarct size and myocardium at risk: evaluation of different 
      techniques and its implications.
PG  - 738-46
LID - 10.1093/ehjci/jev001 [doi]
AB  - AIMS: The aim of this study was to evaluate seven methods for quantifying 
      myocardial oedema [2 standard deviation (SD), 3 SD, 5 SD, full width at half 
      maximum (FWHM), Otsu method, manual thresholding, and manual contouring] from 
      T2-weighted short tau inversion recovery (T2w STIR) and also to reassess these 
      same seven methods for quantifying acute infarct size following ST-segment 
      myocardial infarction (STEMI). This study focuses on test-retest repeatability 
      while assessing inter- and intraobserver variability. T2w STIR and late 
      gadolinium enhancement (LGE) are the most widely used cardiovascular magnetic 
      resonance (CMR) techniques to image oedema and infarction, respectively. However, 
      no consensus exists on the best quantification method to be used to analyse these 
      images. This has potential important implications in the research setting where 
      both myocardial oedema and infarct size are increasingly used and measured as 
      surrogate endpoints in clinical trials. METHODS AND RESULTS: Forty patients day 2 
      following acute reperfused STEMI were scanned for myocardial oedema and 
      infarction (LGE). All patients had a second CMR scan on the same day >6 h apart 
      from the first one. Images were analysed offline by two independent observers 
      using the semi-automated software. Both oedema and LGE were quantified using 
      seven techniques (2 SD, 3 SD, 5 SD, Otsu, FWHM, manual threshold, and manual 
      contouring). Interobserver, intraobserver and test-retest agreement and 
      variability for both infarct size and oedema quantification were assessed. 
      Infarct size and myocardial quantification vary depending on the quantification 
      method used. Overall, manual contouring provided the lowest inter-, 
      intraobserver, and interscan variability for both infarct size and oedema 
      quantification. The FWHM method for infarct size quantification and the Otsu 
      method for myocardial oedema quantification are acceptable alternatives. 
      CONCLUSIONS: This study determines that, in acute myocardial infarction (MI), 
      manual contouring has the lowest overall variability for quantification of both 
      myocardial oedema and MI when analysed by experienced observers.
CI  - (c) The Author 2015. Published by Oxford University Press on behalf of the European 
      Society of Cardiology.
FAU - McAlindon, Elisa
AU  - McAlindon E
AD  - NIHR Bristol Cardiovascular Biomedical Research Unit, Bristol Heart Institute, 
      Level 7 Queens Building, Bristol Royal Infirmary, Bristol BS2 8HW, UK.
FAU - Pufulete, Maria
AU  - Pufulete M
AD  - Clinical Trial and Evaluation Unit (CTEU), University of Bristol, Bristol, UK.
FAU - Lawton, Chris
AU  - Lawton C
AD  - NIHR Bristol Cardiovascular Biomedical Research Unit, Bristol Heart Institute, 
      Level 7 Queens Building, Bristol Royal Infirmary, Bristol BS2 8HW, UK.
FAU - Angelini, Gianni D
AU  - Angelini GD
AD  - NIHR Bristol Cardiovascular Biomedical Research Unit, Bristol Heart Institute, 
      Level 7 Queens Building, Bristol Royal Infirmary, Bristol BS2 8HW, UK.
FAU - Bucciarelli-Ducci, Chiara
AU  - Bucciarelli-Ducci C
AD  - NIHR Bristol Cardiovascular Biomedical Research Unit, Bristol Heart Institute, 
      Level 7 Queens Building, Bristol Royal Infirmary, Bristol BS2 8HW, UK 
      c.bucciarelli-ducci@bristol.ac.uk.
LA  - eng
GR  - Department of Health/United Kingdom
PT  - Comparative Study
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20150302
PL  - England
TA  - Eur Heart J Cardiovasc Imaging
JT  - European heart journal. Cardiovascular Imaging
JID - 101573788
RN  - 0 (Troponin T)
SB  - IM
MH  - Aged
MH  - Cohort Studies
MH  - Edema, Cardiac/*diagnosis/mortality
MH  - Electrocardiography/methods
MH  - Female
MH  - Humans
MH  - *Image Processing, Computer-Assisted
MH  - Magnetic Resonance Imaging, Cine/*methods
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*diagnosis/*mortality/therapy
MH  - Myocardial Reperfusion/methods
MH  - Myocardium/pathology
MH  - Observer Variation
MH  - Prospective Studies
MH  - Risk Assessment
MH  - Severity of Illness Index
MH  - Survival Rate
MH  - Treatment Outcome
MH  - Troponin T/blood
PMC - PMC4463003
OTO - NOTNLM
OT  - Cardiac magnetic resonance
OT  - Infarct size
OT  - Myocardial oedema
OT  - Quantification
EDAT- 2015/03/05 06:00
MHDA- 2016/05/03 06:00
PMCR- 2015/03/03
CRDT- 2015/03/05 06:00
PHST- 2014/06/16 00:00 [received]
PHST- 2014/12/31 00:00 [accepted]
PHST- 2015/03/05 06:00 [entrez]
PHST- 2015/03/05 06:00 [pubmed]
PHST- 2016/05/03 06:00 [medline]
PHST- 2015/03/03 00:00 [pmc-release]
AID - jev001 [pii]
AID - 10.1093/ehjci/jev001 [doi]
PST - ppublish
SO  - Eur Heart J Cardiovasc Imaging. 2015 Jul;16(7):738-46. doi: 10.1093/ehjci/jev001. 
      Epub 2015 Mar 2.