Technical Evaluation of Automated Left Ventricular Quantification in Cardiac Magnetic Resonance Imaging: Comparison with Manual Reference Measurements

BackgroundAutomated left ventricular (LV) quantification may reduce the manual post-processing burden of cardiac magnetic resonance (CMR) imaging but requires evaluation against manual reference meas urements before routine clinical use. PurposeTo evaluate automated CMR post-processing for LV quantification against manual reference meas urements and to compare its performance with Inline scanner-derived measurements. MethodsCMR examinations from 178 patients at a single tertiary referral center were retrospectively evalu ated.Ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and myocardial mass obtained with automated syngo.viapost-processing and Inline scanner analysis were compared with manual expert measurements using intraclass correlation coefficients (ICC), Bland-Altman analysis, root mean square error (RMSE) and mean absolute percentage error (MAPE). ResultsAutomated post-processing showed excellent agreement with manual measurements for all five para meters (ICC 0.957-1.000;MAPE 0.72-3.21%).Bland-Altman mean biases were small: -0.83 per centage points for EF, 0.74 mL for EDV, -1.43 mL for ESV, -1.45 mL for SV and -1.03 g for myocardial mass, although ESV showed wider limits of agreement.Inline measurements showed greater disagreement with the manual reference, including an EF bias of +4.22 percentage points and moderate ICCs for SV (0.733), EDV (0.673) and ESV (0.619), with consistently higher RMSE and MAPE. ConclusionsAutomated CMR post-processing agreed closely with manual reference measurements and showed lower measurement error than Inline scanner-derived measurements, supporting its use to aid routine LV quantification with expert review where segmentation is uncertain.Further multicenter evaluation across scanners and patient populations is warranted.