Evidence map›Paper›PMID 40449736›Full record

ArticleJournal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance

Ex-vivo validation of nine algorithms for quantifying infarcts with late gadolinium enhancement cardiovascular magnetic resonance.

Sascha Kopic, Einar Heiberg, Henrik Engblom, Marcus Carlsson, David Nordlund, Robert Jablonowski, Mikael Kanski, Christos Xanthis, Sebastian Bidhult, Anthony H Aletras and 1 more

Abstract readValidation StudyComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. The severity of post-infarction edema suggests a bimodal pattern, whereas the extent does not.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
    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

11 authors.

Sascha KopicLund University, Department of Clinical Sciences Lund, Clinical Physiology, Skane University Hospital, Lund, Sweden.
Einar HeibergLund University, Department of Clinical Sciences Lund, Clinical Physiology, Skane University Hospital, Lund, Sweden; Lund University, Wallenberg Center for Molecular Medicine, Lund, Sweden.
Henrik EngblomLund University, Department of Clinical Sciences Lund, Clinical Physiology, Skane University Hospital, Lund, Sweden.
Marcus CarlssonLund University, Department of Clinical Sciences Lund, Clinical Physiology, Skane University Hospital, Lund, Sweden.
David NordlundLund University, Department of Clinical Sciences Lund, Clinical Physiology, Skane University Hospital, Lund, Sweden.
Robert JablonowskiLund University, Department of Clinical Sciences Lund, Clinical Physiology, Skane University Hospital, Lund, Sweden.
Mikael KanskiLund University, Department of Clinical Sciences Lund, Clinical Physiology, Skane University Hospital, Lund, Sweden.
Christos XanthisLund University, Department of Clinical Sciences Lund, Clinical Physiology, Skane University Hospital, Lund, Sweden.
Sebastian BidhultLund University, Department of Clinical Sciences Lund, Clinical Physiology, Skane University Hospital, Lund, Sweden.
Anthony H AletrasLund University, Department of Clinical Sciences Lund, Clinical Physiology, Skane University Hospital, Lund, Sweden; School of Medicine, Aristotle University of Thessaloniki, Laboratory of Computing, Medical Informatics and Biomedical - Imaging Technologies, Thessaloniki, Greece.
Håkan ArhedenLund University, Department of Clinical Sciences Lund, Clinical Physiology, Skane University Hospital, Lund, Sweden. Electronic address: Hakan.Arheden@med.lu.se.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn cardiovascular magnetic resonance, late gadolinium enhancement (LGE) is the standard method to visualize myocardial infarction (MI). Many algorithms quantifying infarct size in LGE images exist. However, only few algorithms have been validated, i.e., benchmarked against an ex-vivo measurement. Furthermore, the reported algorithm performance varies considerably between studies.

objectivesThe aim of this study was to compare the performance of all infarct measurement algorithms against an ex-vivo measurement and to promote a discourse regarding advantages and disadvantages of individual measurement methods.

methodsMI was induced in 22 pigs. In-vivo LGE imaging was conducted on d0, d3 or d7 post-MI. For ex-vivo validation infarct was measured using high-resolution T1-weighted images. In-vivo infarct size was measured using the full-width at half-maximum (FWHM), n-SD from remote (2,3,5, and 6 SD), feature analysis and combined thresholding (FACT), expectation maximization-weighted A priori information (EWA), Heiberg-08 and Otsu algorithms and manual delineation. No manual adjustments were made to algorithm delineations.

resultsClear differences in variance and bias were observed between algorithm-based methods, and no method performed optimally in this heterogeneous dataset where the best had a bias of -0.48±3.1, -0.3±4.4%, 2.3±4.2% left ventricle for EWA, FWHM, and FACT, respectively. Manual delineation by experienced observers performed well with a bias of 1.9±5.4%.

conclusionEWA, Heiberg-08, FWHM, and FACT all perform on par with manual delineation, however, Heiberg-08, and FWHM are not suitable for phase sensitive inversion recovery images. The technique used to measure infarct size should be disclosed in clinical trials and in original research. Caution should be applied when comparing datasets employing different infarct quantification methods. Manual infarct delineation by experienced readers remains a reliable technique to measure infarct size.

Indexed as

AlgorithmsContrast MediaImage Interpretation, Computer-AssistedMagnetic Resonance ImagingMyocardial InfarctionMyocardiumOrganometallic CompoundsAnimalsDisease Models, AnimalPredictive Value of TestsReproducibility of ResultsSus scrofaSwineContrast MediaOrganometallic CompoundsAccuracyInfarct sizeLate gadolinium enhancementPrecisionQuantification

Identifiers

PMID40449736
PMCPMC12780287

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Registered trials

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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.