October 7, 2015BioMedical Engineering OnLineOpen Access

Rapid automatic segmentation of abnormal tissue in late gadolinium enhancement cardiovascular magnetic resonance images for improved management of long-standing persistent atrial fibrillation

Q: What is the clinical evidence from this study?

Population: Long-standing persistent atrial fibrillation (n=13). Intervention: Automatic segmentation using global normalized intensity thresholds vs. Other threshold levels and visual inspection. Primary outcome: Optimal global normalized intensity threshold levels for enhancement segmentation.

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Key result

Global normalized intensity threshold levels of 1.25 and 1.625 accurately segmented abnormal tissue in pre-ablation and 3-month post-ablation LGE CMR datasets of patients with long-standing persistent atrial fibrillation.

Population

13 patients with long-standing persistent drug-refractory AF presenting for first-time ablation.

Comparison

Automatic enhancement segmentation of left… vs Other related approaches proposing different…

Follow-up

3 months post-ablation

Authors

AGArchontis GiannakidisAthena Research and Innovation Center In Information Communication & Knowledge Technologies ENEva NyktariOnassis Cardiac Surgery Center JKJennifer KeeganCardiac Imaging

Discussion

Member takes

Implication

May support standardized LGE CMR analysis in persistent AF; leaves open prospective validation before clinical use.

Structured PICO

Population

13 patients (mean age 62 years, 31% female) with long-standing persistent drug-refractory atrial fibrillation undergoing first-time ablation, evaluated with LGE CMR pre-ablation and at 3 months post-ablation.

Intervention

Automatic enhancement segmentation of left atrial wall tissue from 3D LGE CMR data-sets using global normalized intensity thresholds (T PRE = 1 1/4 and T POST = 1 5/8) benchmarked against the statistics of the whole left atrial blood-pool (LABP).

Comparator

Other related approaches proposing different threshold levels for segmenting enhancement in LGE CMR data-sets.

Outcome

Reliable distinction of enhanced (abnormal) from non-enhanced (healthy) tissue within the left atrial wall of pre-ablation and 3 months post-ablation LGE CMR data-sets.surrogate

A novel threshold-based automatic segmentation method for LGE CMR can reliably identify left atrial fibrosis and ablation lesions in patients with long-standing persistent AF.

Limitations

Relatively small sample size
Only one voltage map was available for validation
Reliance on qualitative criteria due to the lack of a reliable gold standard ground truth
Consensus manual delineation of the left atrial wall epicardial border is time-consuming
Inter-centre differences in the CMR acquisition protocol and image analysis strategy inevitably impede the selection of a universally optimal algorithm for segmentation of enhancement in AF studies.

Cite This Study

Giannakidis et al. (2015) studied Long-standing persistent atrial fibrillation (n=13). Automatic segmentation using global normalized intensity thresholds vs. Other threshold levels and visual inspection was evaluated on Optimal global normalized intensity threshold levels for enhancement segmentation. Global normalized intensity threshold levels of 1.25 and 1.625 accurately segmented abnormal tissue in pre-ablation and 3-month post-ablation LGE CMR datasets of patients with long-standing persistent atrial fibrillation.

synapsesocial.com/papers/6a9a4880e87681eadfdeabaf https://doi.org/10.1186/s12938-015-0083-8

Topics

Atrial fibrillation Persistent AF management AF ablation outcomes Anticoagulation in AF

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Rapid automatic segmentation of abnormal tissue in late gadolinium enhancement cardiovascular magnetic resonance images for improved management of long-standing persistent atrial fibrillation

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Topics

Rapid automatic segmentation of abnormal tissue in late gadolinium enhancement cardiovascular magnetic resonance images for improved management of long-standing persistent atrial fibrillation

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

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Topics

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