A second-generation computer-based edge detection algorithm for short-axis, two-dimensional echocardiographic images: accuracy and improvement in interobserver variability.

The present study tested the hypothesis that a second-generation endocardial edge detection algorithm that used a priori endocardial and epicardial information would improve accuracy and reduce the variability of border definition. Five nonexpert observers utilized the version 2 algorithm on 20 cycles of two-dimensional short-axis images (five excellent, seven good, and eight poor quality studies stored digitally from a previously reported project). Manually defined areas by five recognized experts on these 20 cardiac cycles were considered to be "true areas." Areas defined by the experts with version 1 of the algorithm were also used for comparison. Regression of the version 2 areas with mean, manually defined excellent quality areas yielded a similar correlation (r = 0.985) to that reported between the manual and the version 1 areas (r = 0.986). For all 20 cycles in the series, however, the correlation between version 2 and the manually defined areas was lower (r = 0.952) than that of the same correlation with version 1 areas (r = 0.980). For all studies the interobserver variability (percent area difference) was +/- 14.4% for manually defined borders, +/- 11.1% for version 1-defined borders, and +/- 7.7% for version 2-defined borders. No difference in variability was observed for excellent quality studies (+/- 5.3% versus 5.2%) between version 1 and version 2 areas. However, the version 2 algorithm significantly reduced interobserver variability for good and poor quality studies (+/- 8.4% to 7.6%, p less than 0.025, and 16.3% to 9.1%, p less than 0.05, respectively). We concluded that: the version 2 algorithm provided accuracy and significantly reduced the variability of area measurement in good and poor quality studies and that epicardial information was important to the improvement by providing wall thickness information to assist in filling areas of dropout and avoidance of intracavitary structures.