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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Copyright © 2006 by the American Roentgen Ray Society.