Author + information
- Marcelo Souto Nacif, MD, PhD,
- Atul R. Chugh, MD,
- João A.C. Lima, MD, MBA and
- David A. Bluemke, MD, PhD⁎ ()
- ↵⁎National Institutes of Health, Radiology and Imaging Sciences, 10 Center Drive, Bldg 10/1C355, Bethesda, Maryland 20892
In the February 2011 issue of iJACC, we read with great interest the article by Flett et al. (1), in which the authors compared the reproducibility of 7 late gadolinium enhancement (LGE) quantification techniques across 3 clinical conditions. We noted that the authors cite in their introduction and conclusion that the 2-SD method as a threshold for LGE is a guideline-driven recommendation set forth by Kramer et al. (2).
However, the reference to Kramer et al. (2) does not cover this threshold of 2-SD assessment. We did find a 2009 guideline paper by the Society for Cardiovascular Magnetic Resonance (3) that recommended using “more than 2SD” as a cutoff to report scar area on LGE. Note, however, that those guidelines (3) do not specifically address 2-SD as the best method for semiautomatic scar measurement and do not specifically assess other thresholds or threshold methods. We think this is highly relevant because in our experience, and that of other investigators, higher thresholds (4) or alternative (5) methods have been recommended.
This paper is very well done and points out the need for guideline-based assessment to standardize methods for quantitative LGE assessment given its increasing importance in clinical and research studies.
- American College of Cardiology Foundation