Left Ventricular Late Gadolinium Enhancement Assessment for MR
Purpose | Automate late gadolinium enhancement assessment |
Tag(s) |
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Panel | Cardiac |
Define-AI ID | 18040008 |
Originator | Akos Szemes |
Panel Chair | Carlo De Cecco |
Panel Reviewers | Cardiac Panel |
License | |
Status | Published |
Clinical Implementation
Value Proposition
Late gadolinium enhancement (LGE) can be observed in several myocardial pathologies, including different stages of myocardial infarction (MI), myocarditis, and certain cardiomyopathies. The clinical assessment of LGE is primarily qualitative, with descriptions of the location and number of affected segments, or semiquantitative, such as LGE transmurality. Although latter techniques allow for fast interpretation, the accurate quantification of MI has become necessary to systematically analyze the association of MI size with short- and long-term effects, associated complications, and general prognoses. It has been shown that the size of MI correlates with ejection fraction, predicts segmental functional outcome after revascularization, prognosticates recovery of left ventricular function, and shows association with the occurrence of spontaneous ventricular arrhythmias. Automated LGE quantification would save time and eliminate subjectivity from the analysis.Narrative(s)
All patients undergoing contrast-enhanced cardiovascular magnetic resonance imaging (CMR) examinations should have automated quantification of LGE if data are available, which should then be automatically populated into the radiology report or a report supplement.Workflow Description
A patient receives contrast-enhanced MRI of the heart, with LGE acquisition included. An algorithm retrieves input from the imaging data set, relevant EMR data (including age, sex, and body surface area [BSA; m2]), and user-selected quantification methods (standard deviation [SD] based: 2 or 5 SD and full width at half maximum). The algorithm automatically segments the borders of the LV endocardium and LV epicardium on LGE data sets and identifies the base and apex of the heart; the LV myocardium (the area between the epicardium and endocardium) automatically segmented to identify normal and enhanced myocardium based on the quantification method selected. The algorithm then detects affected myocardium segments based on the 17-segment American Heart Association model and determines transmurality in these segments (<25%, 25-50%, 51-75%, and >75%). With this information, the algorithm calculates absolute myocardial mass (LVM; mL and g), total LGE volume (mL), LGE percentage (%LVM), segmental LGE volume (mL), LGE percentage (%), and BSA-indexed LVM (g/m2). The measurements are returned and automatically populated into the report. Segmental assessment is visualized on a color-coded polar map also indicating coronary artery territories. The algorithm flags abnormal LVM values.Considerations for Dataset Development
Procedures(s): Contrast enhanced cardiac MRI with LGE acquisition
View(s): {short-axis LGE images, long-axis 4-chamber LGE images, long-axis 2-chamber LGE images, long-axis left ventricular outflow tract LGE images}
Sex at Birth: {Male, Female}
Age: [0,90]
Body Surface Area: varied
Comorbidities: {Congenital heart disease, ventricular septal defects}
Intervention: {Congenital heart disease repair, mitral valve replacements, coronary artery bypass graft, alcohol ablation in hypertrophic cardiomyopathy, etc}
Contrast: contrast-enhanced MRI
Technical Specifications
Inputs
DICOM Study
Procedure | Contrast-enhanced cardiac MRI with LGE acquisition |
Views | CMR: short-axis LGE images, long-axis 4-chamber LGE images, long-axis 2-chamber LGE images, long-axis LVOT LGE images |
Data Type | DICOM |
Modality | CMR |
Body Region | Chest |
Anatomic Focus | Heart |
Primary Outputs
Number of segments with LGE
RadElement ID | |
Definition | Number of segments with LGE based on the AHA model |
Data Type | Numeric |
Value Set |
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Units |
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List of Segments with LGE
RadElement ID | |
Definition | List of segments with LGE (displayed on polar map) |
Data Type | Segmentation value according to AHA segmentation |
Value Set | 1-basal anterior 2-basal anteroseptal 3-basal inferoseptal 4-basal inferior 5-basal inferolateral 6-basal anterolateral 7-mid anterior 8-mid anteroseptal 9-mid inferoseptal 10-mid inferior 11-mid inferolateral 12-mid anterolateral 13-apical anterior 14-apical septal 15-apical inferior 16-apical lateral 17-apex |
Units | N/A |
Transmurality of LGE
RadElement ID | |
Definition | Transmurality of LGE in each segment (displayed on polar map) |
Data Type | Numeric |
Value Set |
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Units | Percentage |
Total LGE Volume
RadElement ID | RDE228 |
Volume of LGE in the LV (mL) | |
Data Type | Numeric |
Value Set |
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Units | mL |
Total Percentage of LGE
RadElement ID | |
Definition | Total percentage of LGE in the LV (%) |
Data Type | Numeric |
Value Set | [0,100] |
Units | Percentage |
Segmental Volume of LGE
RadElement ID | RDE230 |
Definition | Volume of LGE based on the AHA model (displayed on polar map) |
Data Type | Numeric |
Value Set |
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Units | mL |
Segmental Percentage of LGE
RadElement ID | RDE231 |
Definition | Percentage of LGE based on the AHA model (displayed on polar map) |
Data Type | Numeric |
Value Set | [0,100] |
Units | Percentage |
Secondary Outputs
Myocardial Mass (mL)
RadElement ID | RDE232 |
Definition | Myocardial mass (ml) |
Data Type | Numeric |
Value Set |
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Units | mL |
Myocardial Mass (g)
RadElement ID | |
Definition | Myocardial mass (ml) |
Data Type | Numeric |
Value Set |
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Units | mL |
Indexed Myocardial Mass
RadElement ID | RDE234 |
Definition | Myocardial Mass Indexed to body surface area (g/m2) |
Data Type | Numeric |
Value Set |
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Units | mL |
Related Datasets
No known related public datasets at this time, please alert us if you know of any.