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MDCT of Right Ventricular Function: Impact of Methodologic Approach in Estimation of Right Ventricular Ejection Fraction, Part 2

Martine Remy-Jardin1, Damien Delhaye1, Antoine Teisseire1, Claude Hossein-Foucher2, Alain Duhamel3 and Jacques Remy1

1 Department of Thoracic Imaging, Hospital Calmette, University Center of Lille, Blvd. Jules Leclerq, Lille 59037, France.
2 Department of Nuclear Medicine, Hospital Roger Salengro, Lille 59037, France.
3 Department of Medical Statistics, University of Lille, Lille 59037, France.


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  		Fig. 1 —Flowchart shows methodologic approach followed by each reviewer to evaluate interobserver variability in assessment of right ventricular ejection fraction (RVEF) with MDCT. First step was to investigate influence of operator technique on determination of reconstruction window for diastolic and systolic phases, assessed by comparing concordant and discordant selections between reviewer 1 and reviewer 2 in step 1, reconstruction window. Interobserver variability in manual segmentation process was evaluated by comparing end-systolic (ESV) and end-diastolic (EDV) right ventricular volumes obtained by each reviewer after concordant selections of reconstruction windows by both reviewers (step 2, segmentation process).The variability of RVEF measurements with CT was investigated by comparing each reviewer's measurement on MDCT with that obtained on equilibrium radionuclide ventriculography (step 3, MDCT vs scintigraphy). Agreements between two reviewers and between MDCT and scintigraphy were assessed by means of intraclass correlation coefficient. Agreement was also assessed by Bland-Altman method and by mean absolute percent error.

 

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  		Fig. 2 —Bland-Altman plot of mean difference of right ventricular ejection fractions between two reviewers. Broken line represents mean difference. Solid lines represent the 95% confidence intervals for mean difference.

 

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