A fully automated software platform for structural mitral valve analysis
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COMPUTED TOMOGRAPHY
A fully automated software platform for structural mitral valve analysis Robert Steinbach 1 & U. Joseph Schoepf 1 & L. Parkwood Griffith 1 & Marly van Assen 1 & Matthias Renker 2 & Pooyan Sahbaee 3 & Chris Schwemmer 4 & Andreas M. Fischer 1 & Akos Varga-Szemes 1 & Simon S. Martin 1,5 & Richard R. Bayer II 1 Received: 23 October 2019 / Revised: 10 April 2020 / Accepted: 26 May 2020 # European Society of Radiology 2020
Abstract Objective To evaluate a novel fully automated mitral valve analysis software platform for cardiac computer tomography angiography (CCTA)-based structural heart therapy procedure planning. Methods The study included 52 patients (25 women; mean age, 66.9 ± 12.4 years) who had undergone CCTA prior to transcatheter mitral valve replacement (TMVR) or surgical mitral valve intervention (replacement or repair). Therapeutically relevant mitral valve annulus parameters (projected area, circumference, trigone-to-trigone (T-T) distance, anterior-posterior (AP) diameter, and anterolateral-posteromedial (AL-PM) diameter) were measured. Results of the fully automated mitral valve analysis software platform with and without manual adjustments were compared with the reference standard of a user-driven measurement program (3mensio, Pie Medical Imaging). Measurements were compared between the fully automated software, both with and without manual adjustment, and the user-driven program using intraclass correlation coefficients (ICC). A secondary analysis included the time to obtain all measurements. Results Fully automated measurements showed a good to excellent agreement (circumference, ICC = 0.70; projected area, ICC = 0.81; T-T distance, ICC = 0.64; AP, ICC = 0.62; and AL-PM diameter, ICC = 0.78) compared with the user-driven analysis. There was an excellent agreement between fully automated measurement with manual adjustments and user-driven analysis regarding circumference (ICC = 0.91), projected area (ICC = 0.93), T-T distance (ICC = 0.80), AP (ICC = 0.78), and AL-PM diameter (ICC = 0.79). The time required for mitral valve analysis was significantly lower using the fully automated software with manual adjustments compared with the standard assessment (134.4 ± 36.4 s vs. 304.3 ± 77.7 s) (p < 0.01). Conclusion The fully automated mitral valve analysis software, when combined with manual adjustments, demonstrated a strong correlation compared with the user-driven software while reducing the total time required for measurement. Key Points • The novel software platform allows for a fully automated analysis of mitral valve structures. • An excellent agreement was found between the fully automated measurement with manual adjustments and the user-driven analysis. • The software showed quicker measurement time compared with the standard analysis of the mitral valve. Keywords Mitral valve . Transcatheter mitral valve replacement . Automated mitral valve analysis . Computed tomography Richard R. Bayer and Simon S. Martin contributed equally to this work and share senior authorship. * U. Joseph
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