Semi-automated analysis of infarct heterogeneity on DE-MRI using graph cuts

Background Two popular methods for determining the threshold values for the infarct core and gray zone on delayed enhancement MR images (DE-MRI) have been proposed previously: full width and half maximum (FWHM) and standard deviation (SD) methods [1]. Major limitations of these methods are:1) three manually drawn contours are needed for endocardial, epicardial and remote myocardium boundaries, which is time consuming and suffers from inter-observer and intra-observer variability; 2) the difficulty in reproducible manual delineation of remote myocardium, is an important contributor to variability in results; and 3) the dependence on the remote region statistics is problematic due to the low SNR of this region [2]. The purpose of this research was to develop a novel algorithm for segmentation of infarct core and gray zone from conventional IR-GRE shortaxis MR images with highly robust and reproducible results comparable to the FWHM analysis while eliminating the requirement for drawing a remote myocardial region.