Key result
Method C (method of discs) was the most accurate and reproducible method for 3D volume quantification in an irregular phantom heart model, though it was the most time-consuming.
In a dynamic heart phantom model, manual method of discs was the most accurate for 3D echocardiography volume quantification, while manual correction of semi-automated contours reduced tracking consistency.
Several methods of analysis are available for quantification of left ventricular volumes and ejection fraction using three-dimensional (3D) echocardiography. This study compared the accuracy and reproducibility of five methods of analysis in a novel, irregularly shaped dynamic heart phantom with excellent image quality. Five 3D datasets were acquired on a Philips IE33 platform using an X5-1 3D transducer. Each dataset was analysed by five different methods using the Philips QLab v8.1 software: Methods A1, A2 and A3, semi-automated contour detection with varying degrees of user correction; Method B, Simpson's biplane method using optimally aligned four- and two-chamber views and Method C, method of discs, manually delineated in reconstructed short-axis views. Time-volume curves were generated for each method and compared with the true volumes measured throughout systole in the phantom heart. A second observer repeated measurements by each method in a single 3D dataset. Method A1 (uncorrected semi-automated contouring) produced the most consistent time-volume curves, although end-diastolic and end-systolic volumes varied between datasets. Any manual correction of contours (Methods A2, A3 and B) resulted in significant variation in the time-volume curves, with less consistent endocardial tracking. Method C was not only the most accurate and reproducible method, but also the most time-consuming one. Different methods of 3D volume quantification vary significantly in accuracy and reproducibility using an irregular phantom heart model. Although contouring may appear optimal in long-axis views, this may not be replicated circumferentially, and the resulting measures appeared to be less robust following the manual correction of semi-automated contours.
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Wood et al. (2014) studied this question. Method C (method of discs) vs. Semi-automated contour detection and Simpson's biplane method was evaluated on Accuracy and reproducibility of time-volume curves compared with true volumes. Method C (method of discs) was the most accurate and reproducible method for 3D volume quantification in an irregular phantom heart model, though it was the most time-consuming.
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