Efficacy and Accuracy of Novel Automated Mitral Valve Quantification: Three-Dimensional Transesophageal Echocardiographic Study

Echocardiography. 2016 May;33(5):756-63. doi: 10.1111/echo.13135. Epub 2015 Dec 13.

Abstract

Background: Previous studies indicated that the three-dimensional features of the mitral valve (MV) have a significant impact on MV disease. However, quantification of MV with manual tracing software was too time-consuming for routine clinical practice. This study was performed to investigate the efficacy and accuracy of MV quantification with a novel highly automated commercially available software package developed for this purpose.

Methods: Using the manual tracing and automated package, two expert sonographers and one cardiologist individually analyzed three-dimensional datasets acquired with transesophageal echocardiography from 74 patients (15 with functional mitral regurgitation, 32 with MV prolapse, and 27 normal subjects) retrospectively. Time for analysis and inter-observer agreement were compared between the two methods, and agreement of measurements was analyzed using Cronbach's α.

Results: Time for analysis using the automated package was significantly shorter than manual tracing (whole cohort, 260 ± 65 vs. 381 ± 68 seconds, P < 0.001; functional mitral regurgitation, 234 ± 42 vs. 378 ± 64 seconds, P < 0.001; MV prolapse, 293 ± 69 vs. 407 ± 67 seconds, P < 0.001; normal controls, 235 ± 52 vs. 351 ± 60 seconds, P < 0.001). There was good agreement among all three observers using both methods, and measurements with the automated package agreed well with the manual tracing values.

Conclusions: The novel automated software package reduced time for quantification of MV with similar accuracy compared to the manual method. Automated quantification is useful and may be a key to widespread adoption of three-dimensional quantification in clinical practice.

Keywords: mitral regurgitation; mitral valve; three-dimensional transesophageal echocardiography; transesophageal echocardiography; valvular regurgitation.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Aged
  • Algorithms
  • Echocardiography, Three-Dimensional / methods*
  • Echocardiography, Transesophageal / methods*
  • Female
  • Humans
  • Image Enhancement / methods
  • Image Interpretation, Computer-Assisted / methods
  • Machine Learning
  • Male
  • Mitral Valve / diagnostic imaging*
  • Mitral Valve Insufficiency / diagnostic imaging*
  • Mitral Valve Prolapse / diagnostic imaging*
  • Observer Variation
  • Pattern Recognition, Automated / methods*
  • Reproducibility of Results
  • Sensitivity and Specificity