Silvia Pradella1,2, Lorenzo Nicola Mazzoni3,4, Mayla Letteriello1, Paolo Tortoli4, Silvia Bettarini4, Cristian De Amicis1, Giulia Grazzini5, Simone Busoni4, Pierpaolo Palumbo2,6, Giacomo Belli4, Vittorio Miele1. 1. Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50134, Florence, Italy. 2. Italian Society of Medical and Interventional Radiology, SIRM Foundation, Milan, Italy. 3. Medical Physics Unit Pistoia Prato, Azienda Usl Toscana Centro, Pistoia, Italy. 4. Medical Physics Unit, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy. 5. Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50134, Florence, Italy. grazzini.giulia@gmail.com. 6. Department of Diagnostic Imaging, Area of Cardiovascular and Interventional Imaging, Abruzzo Health Unit 1, L'Aquila, Italy.
Abstract
PURPOSE: Today there is a growing interest in the quantification of late gadolinium enhancement (LGE) in ischemic and non-ischemic cardiac pathologies. We build an automatic self-made free software FLORA (For Late gadOlinium enhanced aReas clAssification) for the recognition, classification and quantification of LGE areas that allows to improve the observer's performances and that homogenizes the evaluations between different operators. MATERIAL AND METHODS: We have retrospectively selected 120 CMR exams: 40-ischemic with evident scar tissue on LGE sequences; 40-non-ischemic cardiomyopathy; 40-any myocardial alteration on CMR, especially on LGE sequences. FLORA's performance was compared to the radiologist's evaluation. RESULTS: FLORA identified both ischemic and non-ischemic myocardial lesions in almost all cases (80/80 and 79/80 for the double-Gaussian fit method and fixed-shift method, respectively, with sensitivity and specificity of 100%/98.8% and 55%/50%, respectively). The best results were obtained from the classification of ischemic myocardial damage, which was correctly identified in 85%-95% of cases. FLORA also increases the agreement between observers and allows a quantitative evaluation of transmurality. CONCLUSIONS: FLORA has proven to be an applicable tool that improves and facilitates the classification of LGE areas allowing their quantification.
PURPOSE: Today there is a growing interest in the quantification of late gadolinium enhancement (LGE) in ischemic and non-ischemic cardiac pathologies. We build an automatic self-made free software FLORA (For Late gadOlinium enhanced aReas clAssification) for the recognition, classification and quantification of LGE areas that allows to improve the observer's performances and that homogenizes the evaluations between different operators. MATERIAL AND METHODS: We have retrospectively selected 120 CMR exams: 40-ischemic with evident scar tissue on LGE sequences; 40-non-ischemic cardiomyopathy; 40-any myocardial alteration on CMR, especially on LGE sequences. FLORA's performance was compared to the radiologist's evaluation. RESULTS: FLORA identified both ischemic and non-ischemic myocardial lesions in almost all cases (80/80 and 79/80 for the double-Gaussian fit method and fixed-shift method, respectively, with sensitivity and specificity of 100%/98.8% and 55%/50%, respectively). The best results were obtained from the classification of ischemic myocardial damage, which was correctly identified in 85%-95% of cases. FLORA also increases the agreement between observers and allows a quantitative evaluation of transmurality. CONCLUSIONS: FLORA has proven to be an applicable tool that improves and facilitates the classification of LGE areas allowing their quantification.
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