Fully Automated Plane Prescription in Cardiac MRI : A Prospective Cohort Study

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BACKGROUND: Accurate plane positioning is important for high-quality cardiac MRI images but requires specialized training, limiting accessibility. PURPOSE: To evaluate an automated plane positioning tool and compare it with manual planning. STUDY TYPE: Prospective. POPULATION: Fifty-seven healthy volunteers (28 males; median age 42 years) and 20 consecutive patients (15 males; median age 61 years) scheduled for clinical cardiac MRI. FIELD STRENGTH/SEQUENCE: Steady state free precession cine sequence at 1.5 T. ASSESSMENT: In volunteers, short-axis (SAX), 2-chamber (2CH), 3-chamber (3CH), and 4-chamber (4CH) cine images were acquired using both automated and manual prescription. Two blinded radiologists (5 and 6 years of clinical cardiac MRI experience) rated plane quality on a Likert scale (1 = nondiagnostic to 5 = excellent). Mean plane angle differences between manual and automated prescriptions were calculated. Left and right ventricular end-systolic volume (ESV), end-diastolic volume (EDV), stroke volume (SV), and ejection fraction (EF) were compared. In patients, the number of required manual corrections to automated prescriptions was recorded. STATISTICAL ANALYSIS: Wilcoxon matched-pairs signed rank tests and Bland-Altman analyses, significance level at p ≤ 0.05. RESULTS: Automated plane positioning was successful in all volunteers. Image plane quality did not differ significantly between automated (mean score 4.64) and manual prescription (4.62, p = 0.812). Mean angle differences were 6.7° ± 4.3° (SAX), 10.3° ± 5.8° (2CH), 8.9° ± 5.1° (3CH), and 8.0° ± 4.8° (4CH). Volumetric parameters showed no significant differences between both planning methods with mean biases being -0.5 mL, p = 0.305 (LVEDV), 0.5 mL, p = 0.683 (LVESV), -1.0 mL, p = 0.168 (LVSV) and 0.4%, and p = 0.215 (LVEF). In patients, 8.8% (7/80) of automatically prescribed planes required minor corrections; 91.2% (73/80) were accepted without adjustments. DATA CONCLUSION: Automated plane positioning for cardiac MRI may provide high-quality images and accurate volumetric assessment comparable to manual planning. EVIDENCE LEVEL: 2. TECHNICAL EFFICACY: Stage 2.

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