Evaluation of left atrial function by multidetector computed tomography before left atrial radiofrequency-catheter ablation: comparison of a manual and automated 3D volume segmentation method

Eur J Radiol. 2010 Aug;75(2):e141-6. doi: 10.1016/j.ejrad.2010.03.020. Epub 2010 Apr 28.


Introduction: The purpose of this study was to compare a manual and automated 3D volume segmentation tool for evaluation of left atrial (LA) function by 64-slice multidetector-CT (MDCT).

Methods and materials: In 33 patients with paroxysmal atrial fibrillation a MDCT scan was performed before radiofrequency-catheter ablation. Atrial function (minimal volume (LAmin), maximal volume (LAmax), stroke volume (SV), ejection fraction (EF)) was evaluated by two readers using a manual and an automatic tool and measurement time was evaluated.

Results: Automated LA volume segmentation failed in one patient due to low LA enhancement (103HU). Mean LAmax, LAmin, SV and EF were 127.7 ml, 93 ml, 34.7 ml, 27.1% by the automated, and 122.7 ml, 89.9 ml, 32.8 ml, 26.3% by the manual method with no significant difference (p>0.05) and high Pearsons correlation coefficients (r=0.94, r=0.94, r=0.82 and r=0.85, p<0.0001), respectively. The automated method was significantly faster (p<0.001). Interobserver variability was low for both methods with Pearson's correlation coefficients between 0.98 and 0.99 (p<0.0001).

Conclusions: Evaluation of LA volume and function with 64-slice MDCT is feasible with a very low interobserver variability. The automatic method is as accurate as the manual method but significantly less time consuming permitting a routine use in clinical practice before RF-catheter ablation.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Atrial Fibrillation / diagnostic imaging
  • Atrial Fibrillation / physiopathology*
  • Atrial Fibrillation / surgery
  • Atrial Function, Left*
  • Catheter Ablation*
  • Female
  • Heart Atria / diagnostic imaging*
  • Humans
  • Imaging, Three-Dimensional*
  • Male
  • Middle Aged
  • Observer Variation
  • Radiographic Image Interpretation, Computer-Assisted
  • Tomography, X-Ray Computed*