Gröschel Jan, Hadler Thomas, Grassow Leonhard, Saad Hadil, Viezzer Darian, Ammann Clemens, Zange Leonora, von Knobelsdorff-Brenkenhoff Florian, Blaszczyk Edyta, Schulz-Menger Jeanette
Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, ECRC Experimental and Clinical Research Center, Berlin, Germany.
Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, a joint cooperation between Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Berlin, Germany.
CJC Open. 2025 May 13;7(8):1120-1131. doi: 10.1016/j.cjco.2025.05.003. eCollection 2025 Aug.
Cardiovascular magnetic resonance (CMR) is an established cardiovascular imaging (CVI) technique. Deficits in training limit the widespread use of CMR. This study analyzed the influence of CVI experience on segmentation, to define quality standards for teaching and supervision.
Four CMR experts determined left ventricular (LV) and right ventricular (RV) gold-standard contours in end-systole (ES) and end-diastole (ED), by consensus. After a brief teaching session, readers independently performed segmentations. Readers were classified as beginners (no previous experience in CVI), intermediates (previous experience in CVI, but not in CMR), or experts (extensive experience in CVI including CMR). Results were compared, and the cause of deviation was analyzed, using metrics such as the Dice similarity coefficient (DSC).
A total of 46 readers (19 beginners, 21 intermediates, 6 experts) performed image analysis. Using the DSC, we found significant differences in endocardial LV ED contours (median [interquartile range]: beginners, 92.9% [91.9%-93.5%]); intermediates, 93.5% (93.0%-94.1%); experts, 93.9% (93.1%-94.3%); = 0.043) and in myocardial contours (beginners, 79.0% (75.0%-80.9%); intermediates, 80.9% (78.0%-82.4%); experts, 85.0% (79.8%-86.5%); = 0.001). Experts had higher DSC scores for the right ventricle (ES: beginners, 83.8% (81.3%-85.8%); intermediates, 81.7% (79.6%-85.6%); experts, 89.0% (86.6%-89.8%); = 0.003; ED: beginners, 89.2% (88.1%-90.3%); intermediates, 88.6% (87.9%-89.2%); experts, 91.6% (89.8%-93.3%); = 0.002). The disagreements were not traceable in absolute volume and function ( for all > 0.2). Sources of disagreement were related mainly to handling of basal slices.
After a brief standardized teaching session, beginners and intermediates performed chamber quantification consistent with that of experts. Differences, especially in LV mass and RV segmentations, warrant continuous training, ideally accompanied by automatic methods for quality assurance.
心血管磁共振成像（CMR）是一种成熟的心血管成像（CVI）技术。培训不足限制了CMR的广泛应用。本研究分析了CVI经验对分割的影响，以确定教学和监督的质量标准。
四位CMR专家通过共识确定了收缩末期（ES）和舒张末期（ED）左心室（LV）和右心室（RV）的金标准轮廓。经过简短的教学课程后，读者独立进行分割。读者被分为初学者（以前没有CVI经验）、中级者（以前有CVI经验，但没有CMR经验）或专家（有包括CMR在内的广泛CVI经验）。使用Dice相似系数（DSC）等指标比较结果并分析偏差原因。
共有46名读者（19名初学者、21名中级者、6名专家）进行了图像分析。使用DSC，我们发现左心室内膜舒张末期轮廓存在显著差异（中位数[四分位间距]：初学者，92.9%[91.9%-93.5%]；中级者，93.5%[93.0%-94.1%]；专家，93.9%[93.1%-94.3%]；P = 0.043）以及心肌轮廓（初学者，79.0%[75.0%-80.9%]；中级者，80.9%[78.0%-82.4%]；专家，85.0%[79.8%-86.5%]；P = 0.001）。专家在右心室的DSC评分更高（ES：初学者，83.8%[81.3%-85.8%]；中级者，81.7%[79.6%-85.6%]；专家，89.0%[86.6%-89.8%]；P = 0.003；ED：初学者，89.2%[88.1%-90.3%]；中级者，88.6%[87.9%-89.2%]；专家，91.6%[89.8%-93.3%]；P = 0.002）。在绝对容积和功能方面，差异无法追溯（所有P>0.2）。分歧来源主要与基底部切片的处理有关。
经过简短的标准化教学课程后，初学者和中级者进行的腔室量化与专家一致。差异，尤其是在左心室质量和右心室分割方面，需要持续培训，理想情况下应伴有自动质量保证方法。
