Three-Dimensional Field Optimization Method: Gold-Standard Validation of a Novel Color Doppler Method for Quantifying Mitral Regurgitation.
Background: Accurate diagnosis of mitral regurgitation (MR) severity is central to proper treatment. Although numerous approaches exist, an accurate, gold-standard clinical technique remains elusive. The authors previously reported on the initial development and demonstration of the automated three-...
| Published in: | Journal of the American Society of Echocardiography Vol. 29; no. 10; pp. 917 - 926 |
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| Main Authors: | , , , , , , , |
| Format: | research Journal Article |
| Published: |
Elsevier B.V.
Oct2016
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=119348746&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 119348746 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 08947317 4CO jtl: Journal of the American Society of Echocardiography issn: 08947317 maglogo: N pubinfo: dt: Oct2016 vid: 29 iid: 10 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 119348746 119348746 NLM27354250 119348746 10.1016/j.echo.2016.05.009 NLM27354250 119348746 ppf: 917 ppct: 9 formats: tig: atl: Three-Dimensional Field Optimization Method: Gold-Standard Validation of a Novel Color Doppler Method for Quantifying Mitral Regurgitation. aug: au: Pierce, Eric L Rabbah, Jean Pierre M Thiele, Karl Wei, Qifeng Vidakovic, Brani Jensen, Morten O Hung, Judy Yoganathan, Ajit P affil: The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia sug: subj: Image Enhancement Standards Mitral Valve Insufficiency Image Enhancement Methods Echocardiography, Three-Dimensional Methods Echocardiography, Doppler, Color Methods Echocardiography, Three-Dimensional Standards Echocardiography, Doppler, Color Standards Sensitivity and Specificity Reproducibility of Results In Vitro Studies Animal Studies Sheep Observer Bias Reference Values Validation Studies Comparative Studies Evaluation Research Multicenter Studies ab: Background: Accurate diagnosis of mitral regurgitation (MR) severity is central to proper treatment. Although numerous approaches exist, an accurate, gold-standard clinical technique remains elusive. The authors previously reported on the initial development and demonstration of the automated three-dimensional (3D) field optimization method (FOM) algorithm, which exploits 3D color Doppler ultrasound imaging and builds on existing MR quantification techniques. The aim of the present study was to extensively validate 3D FOM in terms of accuracy, ease of use, and repeatability.Methods: Three-dimensional FOM was applied to five explanted ovine mitral valves in a left heart simulator, which were systematically perturbed to yield a total of 29 unique regurgitant geometries. Three-dimensional FOM was compared with a gold-standard flow probe, as well as the most clinically prevalent MR volume quantification technique, the two-dimensional (2D) proximal isovelocity surface area (PISA) method.Results: Overall, 3D FOM overestimated and 2D PISA underestimated MR volume, but 3D FOM error had smaller magnitude (5.2 ± 9.9 mL) than 2D PISA error (-6.9 ± 7.7 mL). Two-dimensional PISA remained superior in diagnosis for round orifices and especially mild MR, as predicted by ultrasound physics theory. For slit-type orifices and severe MR, 3D FOM showed significant improvement over 2D PISA. Three-dimensional FOM processing was technically simpler and significantly faster than 2D PISA and required fewer ultrasound acquisitions. Three-dimensional FOM did not show significant interuser variability, whereas 2D PISA did.Conclusions: Three-dimensional FOM may provide increased clinical value compared with 2D PISA because of increased accuracy in the case of complex or severe regurgitant orifices as well as its greater repeatability and simpler work flow. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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