1 / 20

Relationship of Image Quality to Decision Accuracy for ARVC/D in MRI

Relationship of Image Quality to Decision Accuracy for ARVC/D in MRI. Elizabeth Krupinski, PhD Theron Ovitt, MD University of Arizona. ARVC/D. Arrhythmogenic right ventricular cardiomyopathy / dysplasia RV muscle replaced by fatty &/or fibrous tissue Progressive  arrhythmic death.

ronda
Download Presentation

Relationship of Image Quality to Decision Accuracy for ARVC/D in MRI

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Relationship of Image Quality to Decision Accuracy for ARVC/D in MRI Elizabeth Krupinski, PhD Theron Ovitt, MD University of Arizona

  2. ARVC/D • Arrhythmogenic right ventricular cardiomyopathy / dysplasia • RV muscle replaced by fatty &/or fibrous tissue • Progressive  arrhythmic death

  3. ARVC/D • Most common  15 – 40 • Premature ventricular beats • Ventricular tachycardia left bundle branch block morphology • Sudden cardiac death uncommon but may be 1st sign • Familial 30 – 50% cases

  4. Use of MRI • Differential diagnosis - RV outflow tract tachycardia (RVOT) • Characterizes fat in free wall by  signal intensity • Shows contraction abnormalities of RV

  5. Rationale • Acquisition protocols vary • Image quality not studied • Artifacts not studied • Reader performance not studied

  6. Cases • 45 static MRI films • ARVC/D registry UofA • 7 met Task Force criteria • 31 suspected clinical signs • 7 imaged other reasons

  7. Readers • 12 experienced cardiac MRI radiologists • 1 cardiologist expertise in MRI • 13 different institutions US, Canada, Europe

  8. Reading Protocol • Cases  randomly 4 groups • Mailed independently • ~ 1 month between mailings • Pre-formatted response sheet • 6 clinical questions • 3 image quality questions

  9. Image Quality

  10. Motion Artifacts

  11. Other Artifacts

  12. IQ & Motion Artifacts • Inverse relationship • No  mild = good  excellent • Moderate  severe = fair  poor • X2 = 159.413, df = 9, p < 0.0001

  13. IQ & Other Artifacts • Inverse relationship • No  mild = good  excellent • Moderate  severe = fair  poor • X2 = 135.82, df = 9, p < 0.0001

  14. ARVC/D Decisions X2 = 6.756, df = 2, p = 0.034

  15. Decisions x IQ X2 = 11.74 df = 9 p = 0.2281

  16. Reader Agreement • 1/45 (2%) complete agree • No ARVD • All agree absent • Kappa = 0.052 • Very low • Poor discriminability

  17. Other Indicators • If present =>  ARVC/D present • Fat in myocardium • Enlarged RV chamber size • RV configuration abnormal

  18. Other Indicators • No relationship with ARVC/D present • LV chamber size • Myocardium fat location • Anterior wall • RV OT • RV apex

  19. Conclusions • Inter-observer variability high • ARVC/D absent > present • Task Force = Suspected • Certain signs  probability ARVC/D reported present but inconsistent

  20. Conclusions • No established imaging protocol • Reduces IQ • Optimal views? • Motion & other artifacts • Different MRI equipment • Lack cine for wall motion abnormalities

More Related