Automated frame-by-frame endocardial border detection from cardiac magnetic resonance images for quantitative assessment of left ventricular function: Validation and clinical feasibility

Purpose: To develop a technique based on image noise distribution for automated endocardial border detection from cardiac magnetic resonance (CMR) images throughout the cardiac cycle, validate it, and test its clinical utility. Materials and Methods: Images obtained in 36 patients were analyzed using custom software to obtain left ventricular (LV) volume throughout the cardiac cycle, end-systolic and end-diastolic LV volumes, and ejection fraction (EF). Validation against manually-traced endocardial boundaries included intertechnique comparisons of LV volumes, slice areas, and border positions. Then, the clinical feasibility of the dynamic automated analysis of LV function was tested in 14 patients with normal LV function, 12 patients with systolic dysfunction, and 10 patients with diastolic dysfunction. Results: Analysis time for one cardiac cycle was< 15minutes. Intertechnique comparisons resulted in high correlation (r > 0.96), small biases (volumes: -6 mL; EF: 4.6%) and narrow limits of agreement (volumes: 17.6 mL; EF: 9.2%). We found significant intergroup differences in multiple quantitative indices of systolic and diastolic function. Conclusion: Fast, automated, dynamic detection of LV endocardial boundaries is feasible and allows accurate quantification of LV size and function, which is potentially clinically useful for objective assessment of systolic and diastolic dysfunction.