Right ventricular endocardial segmentation in CMR images using a novel inter-modality statistical shape modelling approach

Statistical shape modelling (SSM) approaches have been proposed as a powerful tool to segment the left ventricle in cardiac magnetic resonance (CMR) images. Our aim was to extend this method to segment the RV cavity in CMR images and validate it compared to the conventional gold-standard (GS) manual tracing. A SSM of the RV was built using a database of 4347 intrinsically 3D surfaces, extracted from transthoracic 3D echo cardiographic (3DE) images of 219 retrospective patients. The SSM was then scaled and deformed on the base of some features extracted, with different strategies, from each short-axis plane until a stable condition was reached. The proposed approach, tested on 14 patients, resulted in a high correlation (r2=0.97) and narrow limits of agreement (± 17% error) when comparing the semiautomatic volumes to the GS, confirming the accuracy of this approach in segmenting the RV endocardium.