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-...

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Published in:Journal of the American Society of Echocardiography Vol. 29; no. 10; pp. 917 - 926
Main Authors: Pierce, Eric L, Rabbah, Jean Pierre M, Thiele, Karl, Wei, Qifeng, Vidakovic, Brani, Jensen, Morten O, Hung, Judy, Yoganathan, Ajit P
Format: research Journal Article
Published: Elsevier B.V. Oct2016
Online Access:View this record in EBSCOhost
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      dt: Oct2016
      vid: 29
      iid: 10
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      pub: Elsevier B.V.
      place: New York, New York
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        119348746
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        10.1016/j.echo.2016.05.009
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        119348746
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        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
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