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Importance of standardized assessment of late gadolinium enhancement for quantification of infarct size by cardiac magnetic resonance: implications for comparison with electrocardiogram.

Welinder, Annika LU ; Hakacova, Nina; Martin, Thomas and Engblom, Henrik LU (2011) In Journal of Electrocardiology 44(5). p.538-543
Abstract
BACKGROUND:

Cardiac magnetic resonance (CMR) is currently considered the reference standard for in vivo assessment of myocardial infarction (MI). There is, however, no international consensus on how MI quantification from CMR should be performed. The aim of this study was to test how previously published manual quantification of MI using CMR images compares with MI quantification using a semiautomated, validated method and how this impacts the relationship with MI size estimated by 12-lead electrocardiogram (ECG).



METHODS:

Twenty-five patients, from a previously published cohort, were included in the study. All patients had presented with clinical signs of acute coronary syndrome 6 to 12 months before... (More)
BACKGROUND:

Cardiac magnetic resonance (CMR) is currently considered the reference standard for in vivo assessment of myocardial infarction (MI). There is, however, no international consensus on how MI quantification from CMR should be performed. The aim of this study was to test how previously published manual quantification of MI using CMR images compares with MI quantification using a semiautomated, validated method and how this impacts the relationship with MI size estimated by 12-lead electrocardiogram (ECG).



METHODS:

Twenty-five patients, from a previously published cohort, were included in the study. All patients had presented with clinical signs of acute coronary syndrome 6 to 12 months before undergoing a CMR examination. The patients had a standard 12-lead ECG recorded at the time of the CMR examination. The previously reported manually quantified MI size was compared with MI size determined using a semiautomated method validated by computer phantom data, experimental in vivo and ex vivo data, and patient data. The MI sizes from the 2 CMR approaches were then compared with the ECG-estimated MI size.



RESULTS:

There was a strong correlation between MI size determined with the 2 CMR methods (r(2) = 0.94, P < .001). There was, however, a systematic overestimation of MI size of approximately 50% by the previously published manually quantified MI size compared with the semiautomated method. This affected the comparison with estimated MI size by ECG, which showed a significant underestimation of MI size compared with manual CMR measurements, but no bias compared with the semiautomated CMR method.



CONCLUSIONS:

Manual quantification of MI size by CMR can differ significantly from semiautomated, validated methods taking partial volume effects into account and can lead to erroneous conclusions when compared with ECG. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Electrocardiology
volume
44
issue
5
pages
538 - 543
publisher
Elsevier
external identifiers
  • wos:000294742000009
  • pmid:21872000
  • scopus:80052183474
ISSN
1532-8430
DOI
10.1016/j.jelectrocard.2011.06.007
language
English
LU publication?
yes
id
ea97ab70-aeb0-4b16-b44c-9377621eab56 (old id 2150623)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21872000?dopt=Abstract
date added to LUP
2011-09-04 22:47:27
date last changed
2017-01-01 07:40:32
@article{ea97ab70-aeb0-4b16-b44c-9377621eab56,
  abstract     = {BACKGROUND:<br/><br>
Cardiac magnetic resonance (CMR) is currently considered the reference standard for in vivo assessment of myocardial infarction (MI). There is, however, no international consensus on how MI quantification from CMR should be performed. The aim of this study was to test how previously published manual quantification of MI using CMR images compares with MI quantification using a semiautomated, validated method and how this impacts the relationship with MI size estimated by 12-lead electrocardiogram (ECG).<br/><br>
<br/><br>
METHODS:<br/><br>
Twenty-five patients, from a previously published cohort, were included in the study. All patients had presented with clinical signs of acute coronary syndrome 6 to 12 months before undergoing a CMR examination. The patients had a standard 12-lead ECG recorded at the time of the CMR examination. The previously reported manually quantified MI size was compared with MI size determined using a semiautomated method validated by computer phantom data, experimental in vivo and ex vivo data, and patient data. The MI sizes from the 2 CMR approaches were then compared with the ECG-estimated MI size.<br/><br>
<br/><br>
RESULTS:<br/><br>
There was a strong correlation between MI size determined with the 2 CMR methods (r(2) = 0.94, P &lt; .001). There was, however, a systematic overestimation of MI size of approximately 50% by the previously published manually quantified MI size compared with the semiautomated method. This affected the comparison with estimated MI size by ECG, which showed a significant underestimation of MI size compared with manual CMR measurements, but no bias compared with the semiautomated CMR method.<br/><br>
<br/><br>
CONCLUSIONS:<br/><br>
Manual quantification of MI size by CMR can differ significantly from semiautomated, validated methods taking partial volume effects into account and can lead to erroneous conclusions when compared with ECG.},
  author       = {Welinder, Annika and Hakacova, Nina and Martin, Thomas and Engblom, Henrik},
  issn         = {1532-8430},
  language     = {eng},
  number       = {5},
  pages        = {538--543},
  publisher    = {Elsevier},
  series       = {Journal of Electrocardiology},
  title        = {Importance of standardized assessment of late gadolinium enhancement for quantification of infarct size by cardiac magnetic resonance: implications for comparison with electrocardiogram.},
  url          = {http://dx.doi.org/10.1016/j.jelectrocard.2011.06.007},
  volume       = {44},
  year         = {2011},
}