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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.