Fully automatic segmentation of the left atrium using both MRA and LGE-MRI yielded a surface-to-surface distance of 1.49 mm compared to manual segmentation, outperforming LGE alone (1.80 mm, P<0.05).
Observational (n=46)
Does a fully automatic segmentation method accurately segment the left atrium and pulmonary veins from LGE-MRI compared to manual segmentation in patients with atrial fibrillation?
A fully automatic segmentation method for the left atrium and pulmonary veins from LGE-MRI performs comparably to human observers, potentially enabling objective atrial scar assessment for AF patients.
Absolute Event Rate: 1.49% vs 1.8%
p-value: p=<0.05
PURPOSE: To realize objective atrial scar assessment, this study aimed to develop a fully automatic method to segment the left atrium (LA) and pulmonary veins (PV) from late gadolinium-enhanced (LGE) magnetic resonance imaging (MRI). The extent and distribution of atrial scar, visualized by LGE-MRI, provides important information for clinical treatment of atrial fibrillation (AF) patients. MATERIALS AND METHODS: Forty-six AF patients (age 62 ± 8, 14 female) who underwent cardiac MRI prior to RF ablation were included. A contrast-enhanced MR angiography (MRA) sequence was acquired for anatomy assessment followed by an LGE sequence for LA scar assessment. A fully automatic segmentation method was proposed consisting of two stages: 1) global segmentation by multiatlas registration; and 2) local refinement by 3D level-set. These automatic segmentation results were compared with manual segmentation. RESULTS: The LA and PVs were automatically segmented in all subjects. Compared with manual segmentation, the method yielded a surface-to-surface distance of 1.49 ± 0.65 mm in the LA region when using both MRA and LGE, and 1.80 ± 0.93 mm when using LGE alone (P < 0.05). In the PV regions, the distance was 2.13 ± 0.67 mm and 2.46 ± 1.81 mm (P < 0.05), respectively. The difference between automatic and manual segmentation was comparable to the interobserver difference (P = 0.8 in LA region and P = 0.7 in PV region). CONCLUSION: We developed a fully automatic method for LA and PV segmentation from LGE-MRI, with comparable performance to a human observer. Inclusion of an MRA sequence further improves the segmentation accuracy. The method leads to automatic generation of a patient-specific model, and potentially enables objective atrial scar assessment for AF patients. J. Magn. Reson. Imaging 2016;44:346-354.
Tao et al. (Mon,) conducted a observational in Atrial fibrillation (n=46). Fully automatic segmentation using both MRA and LGE vs. Fully automatic segmentation using LGE alone was evaluated on Surface-to-surface distance in the left atrium region compared with manual segmentation (mm) (p=<0.05). Fully automatic segmentation of the left atrium using both MRA and LGE-MRI yielded a surface-to-surface distance of 1.49 mm compared to manual segmentation, outperforming LGE alone (1.80 mm, P<0.05).