Comparing a Knowledge-based 3D Reconstruction Algorithm to TomTec 3D
Echocardiogram Algorithm in Measuring Left Cardiac Chamber Volumes in
the Pediatric population
Abstract
Background: Three-dimensional echocardiography (3DE) is an
emerging method for volumetric cardiac measurements; however, few
vendor-neutral analysis packages exist. Ventripoint Medical System Plus
(VMS3.0+) proprietary software utilizes a validated MRI database of
normal ventricular and atrial morphologies to calculate chamber volumes.
This study aimed to compare left ventricular (LV) and atrial (LA)
volumes obtained using VMS3.0+ to Tomtec echocardiography analysis
software. Methods: Healthy controls (n=98) aged 0 to 18 years
were prospectively recruited and 3D DICOM datasets focused on the LV and
LA acquired. LV and LA volumes and ejection fractions were measured
using TomTec Image Arena 3D LV analysis package and using VMS3.0+.
Pearson correlation coefficients, Bland-Altman’s plots and intraclass
coefficients (ICC) were calculated, along with analysis time.
Results: There was a very good correlation between VMS and
Tomtec LV systolic (r 2 = 0.88, ICC 0.89 [95% CI
0.81,0.94]), and diastolic (r 2 = 0.88, ICC 0.90
[95% CI 0.77,0.95]) volumes, and between VMS and Tomtec LA
diastolic (r 2 =0.75, ICC 0.89 [95% CI
0.81,0.93]) and systolic (r 2 =0.88, ICC 0.91
[95% CI 0.78,0.96]) volumes on linear regression models. Natural
log transformations eliminated heteroscedasticity, and power
transformations provided best fit. The time (mins) to analyze volumes
using VMS were less than using Tomtec (LV VMS 2.3±0.5, Tomtec 3.3±0.8,
p<0.001; LA: VMS 1.9±0.4, Tomtec 3.4±1.0, p<0.001).
Conclusions: There was very good correlation between
knowledge-based (VMS3.0+) and 3D (Tomtec) algorithms when measuring 3D
echocardiography derived LA and LV volumes in pediatric patients. VMS
was slightly faster than Tomtec in analyzing volumetric measurements.