How to Acquire and Calculate 3D LV and RV Volumes and Ejection Fraction (Three Vendors)

Abstract

Left and right ventricular chamber quantification is essential in clinical practice, and the ejection fraction, despite its limitations, remains one of the most powerful determinants of prognosis and a crucial parameter for guiding therapy. Noninvasive imaging is the mainstay for assessing LV volumes and ejection fraction (EF). Echocardiography, and in particular two-dimensional transthoracic echocardiography (TTE), remains the main modality but has limitations that can be overcome by three-dimensional (3D) echocardiography. 3D volumetric analysis using multiplanar reconstruction offers better visualization and quantification of chamber volumes and function without speculative geometric assumptions. Furthermore, advances in 3D myocardial deformation analysis allow more accurate and reproducible results than conventional 2D strain analysis. 3D echocardiography is also gaining acceptance for the evaluation of right ventricular volumes and ejection fractions. Recent developments in fully automatic quantification algorithms and “artificial intelligence” make 3D quantification easy, fast, and reproducible. As with any 3D image and data acquisition, good 2D image quality and expertise are prerequisites.