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The Need for Standardized Methods for Measuring the Aorta: Multimodality Core Lab Experience From the GenTAC Registry.

by Asch, Federico M; Yuriditsky, Eugene; Weissman, Gaby; Weigold, William Guy; Weissman, Neil J.
Citation: Jacc: Cardiovascular Imaging. 9(3):219-26, 2016 Mar.Journal: JACC. Cardiovascular imaging.Published: 2016ISSN: 1876-7591.Full author list: Asch FM; Yuriditsky E; Prakash SK; Roman MJ; Weinsaft JW; Weissman G; Weigold WG; Morris SA; Ravekes WJ; Holmes KW; Silberbach M; Milewski RK; Kroner BL; Whitworth R; Eagle KA; Devereux RB; Weissman NJ; GenTAC Investigators.UI/PMID: 26897684.Subject(s): Adolescent | Adult | *Aneurysm, Dissecting/dg [Diagnostic Imaging] | Aneurysm, Dissecting/ge [Genetics] | *Aorta, Thoracic/dg [Diagnostic Imaging] | *Aortic Aneurysm, Thoracic/dg [Diagnostic Imaging] | Aortic Aneurysm, Thoracic/ge [Genetics] | *Aortic Rupture/dg [Diagnostic Imaging] | Aortic Rupture/ge [Genetics] | *Aortography/st [Standards] | Consensus | *Echocardiography/st [Standards] | Female | Humans | *Laboratory Proficiency Testing/st [Standards] | *Magnetic Resonance Imaging/st [Standards] | Male | Middle Aged | Observer Variation | Predictive Value of Tests | Registries | Reproducibility of Results | Retrospective Studies | *Tomography, X-Ray Computed/st [Standards] | United States | Young AdultInstitution(s): MedStar Heart & Vascular InstituteActivity type: Journal Article.Medline article type(s): Comparative Study | Journal Article | Multicenter Study | Research Support, N.I.H., ExtramuralDigital Object Identifier: https://dx.doi.org/10.1016/j.jcmg.2015.06.023 (Click here) Abbreviated citation: JACC Cardiovasc Imaging. 9(3):219-26, 2016 Mar.Abstract: OBJECTIVES: This study sought to evaluate variability in aortic measurements with multiple imaging modalities in clinical centers by comparing with a standardized measuring protocol implemented in a core laboratory.Abstract: BACKGROUND: In patients with aortic disease, imaging of thoracic aorta plays a major role in risk stratifying individuals for life-threatening complications and in determining timing of surgical intervention. However, standardization of the procedures for performance of aortic measurements is lacking.Abstract: METHODS: To characterize the diversity of methods used in clinical practice, we compared aortic measurements performed by echocardiography, computed tomography (CT), and magnetic resonance imaging (MRI) at the 6 GenTAC (National Registry of Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions) clinical centers to those performed at the imaging core laboratory in 965 studies. Each center acquired and analyzed their images according to local protocols. The same images were subsequently analyzed blindly by the core laboratory, on the basis of a standardized protocol for all imaging modalities. Paired measurements from clinical centers and core laboratory were compared by mean of differences and intraclass correlation coefficient (ICC).Abstract: RESULTS: For all segments of the ascending aorta, echocardiography showed a higher ICC (0.84 to 0.93) than CT (0.84) and MRI (0.82 to 0.90), with smaller mean of differences. MRI showed higher ICC for the arch and descending aorta (0.91 and 0.93). In a mixed adjusted model, the different imaging modalities and clinical centers were identified as sources of variability between clinical and core laboratory measurements, whereas age groups or diagnosis at enrollment were not.Abstract: CONCLUSIONS: By comparing core laboratory with measurements from clinical centers, our study identified important sources of variability in aortic measurements. Furthermore, our findings with regard to CT and MRI suggest a need for imaging societies to work toward the development of unifying acquisition protocols and common measuring methods.Abstract: Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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