The biplane area-length method significantly underestimated maximum left atrial volume compared with 3D CE-MRA (bias -23.5 mL, P<.001) and 3D LGE MRI (bias -31.3 mL, P<.001) in patients with AF.
Cohort (n=64)
Does the biplane area-length method accurately measure left atrial volume compared to 3D MRI volumetry in patients with atrial fibrillation?
The biplane area-length method significantly underestimates left atrial volume compared to 3D MRI volumetry in patients with atrial fibrillation, suggesting its geometric assumptions are inadequate for this population.
Estimación del efecto: bias: -23.5 mL (vs 3D CE-MRA) and -31.3 mL (vs 3D LGE MRI)
valor p: p=<.001
Purpose To compare maximum left atrial (LA) volume (LAV) from the routinely used biplane area-length (BAL) method with three-dimensional (3D)–based volumetry from late gadolinium-enhanced MRI (3D LGE MRI) and contrast-enhanced MR angiography (3D CE-MRA) in patients with atrial fibrillation (AF). Materials and Methods Sixty-four patients with AF (mean age, 63 years ± 9 SD; 40 male patients) were retrospectively included from a prospective cohort acquired between October 2018 and February 2021. All patients underwent a research MRI examination that included standard two- and four-chamber cine acquisitions, 3D CE-MRA, and 3D LGE MRI performed prior to the atrial kick. Contour delineation on cine imaging and LA 3D segmentations were performed by a radiologist. Maximum LAV (BALmax) was extracted from the BAL volume-time curve and compared with LAV from 3D CE-MRA and 3D LGE MRI. The Kruskal-Wallis test was performed, followed by the Dunn post hoc test and Bland-Altman analyses. Interobserver variability was assessed in 10 patients. Results BALmax underestimated LAV compared with 3D CE-MRA (bias: -23.5 mL ± 46.2, P < .001) and 3D LGE MRI (bias: -31.3 mL ± 58.3, P < .001), whereas 3D LGE MRI volumes showed no evidence of a difference from 3D CE-MRA (bias: 7.8 mL ± 45.7, P = .38). Interobserver variability yielded excellent agreement for each method (intraclass correlation coefficient, 0.96–0.98). Conclusion BALmax underestimated LAV in patients with AF compared with 3D LGE MRI and 3D CE-MRA, suggesting that the geometric assumption of an ellipsoidal LA shape in BAL does not reflect LA geometry in patients with AF. Keywords: Left Atrial Volume, Biplane Area-Length, Late Gadolinium-enhanced 3D MRI, Contrast-enhanced 3D MR Angiography, Atrial Fibrillation Supplemental material is available for this article. © RSNA, 2023
Maroun et al. (Sat,) conducted a cohort in Atrial fibrillation (n=64). Biplane area-length (BAL) method vs. 3D CE-MRA and 3D LGE MRI was evaluated on Maximum left atrial volume (bias: -23.5 mL (vs 3D CE-MRA) and -31.3 mL (vs 3D LGE MRI), p=<.001). The biplane area-length method significantly underestimated maximum left atrial volume compared with 3D CE-MRA (bias -23.5 mL, P<.001) and 3D LGE MRI (bias -31.3 mL, P<.001) in patients with AF.
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