ArticleInsights into imaging2021
Limitations of cardiothoracic ratio derived from chest radiographs to predict real heart size: comparison with magnetic resonance imaging.
Article in Insights into imaging, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Cardiothoracic ratio and left ventricular ejection fraction relationship: A meta-analysis study.Saudi medical journal · 2023Pooled it
- Predictors of echocardiographic abnormalities in asymptomatic individuals with increased cardiothoracic ratio detected on chest radiography.American heart journal plus : cardiology research and practice · 2026Article
- Comparative Evaluation of Feature Selection Strategies for ICU Mortality Prediction Using Chest Radiographic, Radiomic, and Demographic Features.Diagnostics (Basel, Switzerland) · 2026Article
- Rethinking ratio-based normalization towards model-based approaches in heart weight analysis.Scientific reports · 2026Article
- Post-mortem cardiomegaly descriptor: Call for consistent criteria.Journal of forensic sciences · 2025Article
- Designing a computer-assisted diagnosis system for cardiomegaly detection and radiology report generation.PLOS digital health · 2025Article
- New parameter for QRS complex low voltage in chagasic cardiomyopathy: the ADOC index.Revista da Sociedade Brasileira de Medicina Tropical · 2025Article
- Microcardia and cardiomegaly screening using postero-anterior chest X-ray (PA CXR) across university students in Ghana - a retrospective study.BMC medical imaging · 2024Article
- Measurement of Cardiothoracic Ratio on Chest X-rays Using Artificial Intelligence-A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2024Review
- Deep Learning in Cardiothoracic Ratio Calculation and Cardiomegaly Detection.Journal of clinical medicine · 2024Article
- Segmentation-based cardiomegaly detection based on semi-supervised estimation of cardiothoracic ratio.Scientific reports · 2024Article
- The Performance of a Deep Learning-Based Automatic Measurement Model for Measuring the Cardiothoracic Ratio on Chest Radiographs.Bioengineering (Basel, Switzerland) · 2023Article
- Validation of an Automated Cardiothoracic Ratio Calculation for Hemodialysis Patients.Diagnostics (Basel, Switzerland) · 2023Article
- Unsupervised domain adaptation for the detection of cardiomegaly in cross-domain chest X-ray images.Frontiers in artificial intelligence · 2023Article
- Observer performance evaluation of the feasibility of a deep learning model to detect cardiomegaly on chest radiographs.Acta radiologica open · 2022Article
- Clinical Data, Chest Radiograph and Electrocardiography in the Screening for Left Ventricular Hypertrophy: The CARJournal of clinical medicine · 2022Article
- Radiological Cardiothoracic Ratio as a Potential Marker of Left Ventricular Hypertrophy Assessed by Echocardiography.Radiology research and practice · 2022Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCardiothoracic ratio (CTR) in chest radiographs is still widely used to estimate cardiac size despite the advent of newer imaging techniques. We hypothesise that a universal CTR cut-off value of 50% is a poor indicator of cardiac enlargement. Our aim was to compare CTR with volumetric and functional parameters derived from cardiac magnetic resonance imaging (MRI).
methods309 patients with a chest radiograph and cardiac MRI acquired within a month were reviewed to assess how CTR correlates with multiple cardiac MRI variables: bi-ventricular EDV (absolute and indexed to body surface area), EF, indexed total heart volume and bi-atrial areas. In addition, we have also determined CTR accuracy by creating multiple ROC curves with the described variables.
resultsAll cardiac MRI variables correlate weakly but statistically significantly with CTR. This weak correlation is explained by a substantial overlap of cardiac MRI parameters in patients with normal and increased CTR. For all variables, CTR was only mildly to moderately better than a chance to discriminate cardiac enlargement (AUC 0.6-0.7). Large CTR values (> 55%) are specific but not sensitive, while low CTR values (< 45%) are sensitive but not specific. Values in between are not sensitive nor specific.
conclusionsCTR correlates weakly with true chamber size assessed by gold standard cardiac MRI and has a weak discriminatory power. Thus, clinical decisions based on intermediate CTRs (45-55%) should be avoided. Large CTRs (> 55%) are likely indicative of true heart chamber enlargement. Low CTRs (< 45%) are likely indicative of normal heart size.
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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.