Validation of performance of free of charge plugin for the open-source platform to perform cardiac segmentation in magnetic resonance imaging
Wojciech Szychta 1  
Konrad Werys 2  
Marek Postuła 4  
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3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, Bursztynowa 2, 04-749 Warsaw, Poland
Oxford Centre for Clinical Magnetic Resonance Research, John Radcliffe Hospital, Headington, Oxford OX3 9DU, United Kingdom
Department of Pediatric Radiology, Medical University of Warsaw, Żwirki i Wigury 63A, 02-091 Warsaw, Poland
Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland
Faculty of Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, Marymoncka 34, 00-968 Warsaw, Poland
Wojciech Szychta   

3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, Bursztynowa 2, 04-749 Warsaw, Poland
Publish date: 2019-01-01
Heart Beat 2018;3:83–89
Cardiac magnetic resonance (CMR) is the gold standard for heart size, volume and mass calculation, however, dedicated software is needed to perform the segmentation process. The aim of the study was to validate the performance of an open-source CMR segmentation tool against the latest version of vendor-validated CMR42 software.

Material and methods:
We have developed an open source, free of charge plugin called MRHeart for the use on open-source platforms (Osirix/Horos) which allows for detailed segmentation of the heart to obtain basic parameters. We analyzed a mixed group of 20 subjects without and with various cardiac conditions, mean age 51.5 ± 14.0 years.

Substantial agreement (ICC between 0.95 and 0.99) was found for all the analyzed parameters except the RV stroke volume (SV) and RV ejection fraction (EF), where a lower agreement was found (ICC 0.89-0.92). The agreement between both of the analyzed segmentation techniques did not differ from intra- and inter-observer variability of segmentation analysis with MRHeart (p>0.05). The time needed to perform segmentation by means of MRHeart was longer than with CMR42 (LV without mass 4.80 ± 1.13 vs. 1.84 ± 0.77 minutes p<0.0001; LV with mass 7.37 ± 1.82 vs. 3.43 ± 1.04 minutes p<0.0001; RV without mass 5.57 ± 1.22 vs. 2.03 ± 0.93 minutes p<0.0001).

MRHeart is an open-source software which can be used for CMR segmentation analysis with a high precision, which is however slightly better for LV than RV.