Evidence map›Paper›PMID 26946139›Full record

Trial reportBMC medical imaging2016

Automatic segmentation of myocardium at risk from contrast enhanced SSFP CMR: validation against expert readers and SPECT.

Jane Tufvesson, Marcus Carlsson, Anthony H Aletras, Henrik Engblom, Jean-François Deux, Sasha Koul, Peder Sörensson, John Pernow, Dan Atar, David Erlinge and 2 more

2 registry-linked trialsAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in BMC medical imaging, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01374321 phase2completednot on this map

Phase II, Multicenter, Randomized, Double-blind, Placebo Controlled Study to Assess Safety and Efficacy of TRO40303 for Reduction of Reperfusion Injury in Patients Undergoing Percutaneous Coronary Intervention for Acute Myocardial Infarction

TypeinterventionalSponsorHoffmann-La RocheRan2011 to 2013Enrolled168ConditionsAcute Myocardial InfarctusArmsTRO40303, Placebo
NCT01379261 phase2 / phase3completednot on this map

Rapid Endovascular Catheter Core Cooling Combined With Cold Saline as an Adjunct to Percutaneous Coronary Intervention For the Treatment of Acute Myocardial Infarction

TypeinterventionalSponsorRegion SkaneRan2011 to 2013Enrolled120ConditionsMyocardial Infarction, Myocardial Reperfusion Injury, Anterior Wall Myocardial Infarction, Inferior Wall Myocardial InfarctionArmsCooling
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Jane TufvessonDepartment of Clinical Physiology, Skåne University Hospital in Lund, Lund University, Lund, Sweden. jane.tufvesson@med.lu.se.
Marcus CarlssonDepartment of Clinical Physiology, Skåne University Hospital in Lund, Lund University, Lund, Sweden. marcus.carlsson@med.lu.se.
Anthony H AletrasDepartment of Clinical Physiology, Skåne University Hospital in Lund, Lund University, Lund, Sweden. aletras@hotmail.com.
Henrik EngblomDepartment of Clinical Physiology, Skåne University Hospital in Lund, Lund University, Lund, Sweden. henrik.engblom@med.lu.se.
Jean-François DeuxDepartment of Cardiology, Henri Mondor Hospital, Creteil, France. jean-francois.deux@hmn.aphp.fr.
Sasha KoulDepartment of Cardiology, Lund University, Lund, Sweden. sasha.koul@med.lu.se.
Peder SörenssonDepartment of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. peder.sorensson@karolinska.se.
John PernowDepartment of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. john.pernow@ki.se.
Dan AtarDepartment of Cardiology B, Oslo, University Hospital Ullevål and Faculty of Medicine, University of Oslo, Oslo, Norway. dan.atar@online.no.
David ErlingeDepartment of Cardiology, Lund University, Lund, Sweden. david.erlinge@med.lu.se.
Håkan ArhedenDepartment of Clinical Physiology, Skåne University Hospital in Lund, Lund University, Lund, Sweden. hakan.arheden@med.lu.se.
Einar HeibergDepartment of Clinical Physiology, Skåne University Hospital in Lund, Lund University, Lund, Sweden. einar.heiberg@med.lu.se.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEfficacy of reperfusion therapy can be assessed as myocardial salvage index (MSI) by determining the size of myocardium at risk (MaR) and myocardial infarction (MI), (MSI = 1-MI/MaR). Cardiovascular magnetic resonance (CMR) can be used to assess MI by late gadolinium enhancement (LGE) and MaR by either T2-weighted imaging or contrast enhanced SSFP (CE-SSFP). Automatic segmentation algorithms have been developed and validated for MI by LGE as well as for MaR by T2-weighted imaging. There are, however, no algorithms available for CE-SSFP. Therefore, the aim of this study was to develop and validate automatic segmentation of MaR in CE-SSFP.

methodsThe automatic algorithm applies surface coil intensity correction and classifies myocardial intensities by Expectation Maximization to define a MaR region based on a priori regional criteria, and infarct region from LGE. Automatic segmentation was validated against manual delineation by expert readers in 183 patients with reperfused acute MI from two multi-center randomized clinical trials (RCT) (CHILL-MI and MITOCARE) and against myocardial perfusion SPECT in an additional set (n = 16). Endocardial and epicardial borders were manually delineated at end-diastole and end-systole. Manual delineation of MaR was used as reference and inter-observer variability was assessed for both manual delineation and automatic segmentation of MaR in a subset of patients (n = 15). MaR was expressed as percent of left ventricular mass (%LVM) and analyzed by bias (mean ± standard deviation). Regional agreement was analyzed by Dice Similarity Coefficient (DSC) (mean ± standard deviation).

resultsMaR assessed by manual and automatic segmentation were 36 ± 10% and 37 ± 11%LVM respectively with bias 1 ± 6%LVM and regional agreement DSC 0.85 ± 0.08 (n = 183). MaR assessed by SPECT and CE-SSFP automatic segmentation were 27 ± 10%LVM and 29 ± 7%LVM respectively with bias 2 ± 7%LVM. Inter-observer variability was 0 ± 3%LVM for manual delineation and -1 ± 2%LVM for automatic segmentation.

conclusionsAutomatic segmentation of MaR in CE-SSFP was validated against manual delineation in multi-center, multi-vendor studies with low bias and high regional agreement. Bias and variability was similar to inter-observer variability of manual delineation and inter-observer variability was decreased by automatic segmentation. Thus, the proposed automatic segmentation can be used to reduce subjectivity in quantification of MaR in RCT. CLINICAL

trial registrationNCT01379261. NCT01374321.

Indexed as

AlgorithmsHumansMagnetic Resonance AngiographyMyocardial InfarctionMyocardiumObserver VariationValidation Studies as Topic

Identifiers

PMID26946139
PMCPMC4779553

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.