Aortic root evaluation prior to transcatheter aortic valve implantation-Correlation of manual and semi-automatic measurements

Barbora Horehledova*, Casper Mihl, Chris Schwemmer, Babs M. F. Hendriks, Nienke G. Eijsvoogel, Bastiaan L. J. H. Kietselaer, Joachim E. Wildberger, Marco Das

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

6 Citations (Web of Science)

Abstract

Background Pre-procedural TAVI planning requires highly sophisticated and time-consuming manual measurements performed by experienced readers. Semi-automatic software may assist with partial automation of assessment of multiple parameters. The aim of this study was to evaluate differences between manual and semi-automatic measurements in terms of agreement and time. Methods One hundred and twenty TAVI candidates referred for the retrospectively ECG-gated CTA (2nd and 3rd generation dual source CT) were evaluated. Fully manual and semi-automatic measurements of fourteen aortic root parameters were assessed in the 20% phase of the R-R interval. Reading time was compared using paired samples t-test. Inter-software agreement was calculated using the Intraclass correlation coefficient (ICC) in a 2-way mixed effects model. Differences between manual and semi-automatic measurements were evaluated using Bland-Altman analysis. Results The time needed for evaluation using semi-automatic assessment (3 min 24 s +/- 1 min 7 s) was significantly lower (p<0.001) compared to a fully manual approach (6 min 31 sec +/- 1 min 1 sec). Excellent inter-software agreement was found (ICC = 0.93 +/- 0.0; range: 0.90-0.95). The same prosthesis size from manual and semi-automatic measurements was selected in 92% of cases, when sizing was based on annular area. Prosthesis sizing based on annular short diameter and perimeter agreed in 99% and 96% cases, respectively. Conclusion Use of semi-automatic software in pre-TAVI evaluation results in comparable results in respect of measurements and selected valve prosthesis size, while necessary reading time is significantly lower.
Original languageEnglish
Article numbere0199732
Number of pages15
JournalPLOS ONE
Volume13
Issue number6
DOIs
Publication statusPublished - 28 Jun 2018

Keywords

  • MULTIDETECTOR COMPUTED-TOMOGRAPHY
  • HIGH-RISK PATIENTS
  • ANNULAR ASSESSMENT
  • REPLACEMENT TAVR
  • PROSTHESIS
  • STENOSIS
  • REGURGITATION
  • DISEASE
  • MDCT
  • Transcatheter Aortic Valve Replacement
  • Humans
  • Middle Aged
  • Male
  • Tomography, X-Ray Computed
  • Preoperative Care
  • Aorta/diagnostic imaging
  • Aged, 80 and over
  • Adult
  • Female
  • Aged
  • Software
  • Aortography

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