New Solution for Segmental Assessment of Left Ventricular Wall Thickness, Using Anatomically Accurate and Highly Reproducible Automated Cardiac MRI Software

<b>Introduction:</b> Changes in left ventricular (LV) wall thickness serve as important diagnostic and prognostic indicators in various cardiovascular diseases. To date, no automated software exists for the measurement of myocardial segmental wall thickness in cardiac MRI (CMR), which leads to reliance on manual caliper measurements that carry risks of inaccuracy. <b>Aims:</b> This paper aims to present a new automated segmental wall thickness measurement software, OptiLayer, developed to address this issue and to compare it with the conventional manual measurement method. <b>Methods:</b> In our pilot study, the algorithm of the OptiLayer software was tested on 50 HEALTHY individuals, and 50 excessively trabeculated noncompaction (LVET) subjects with preserved LV function, whose morphology makes it more challenging to measure left ventricular wall thickness, although often occurring with myocardial thinning. Measurements were performed by two independent investigators who assessed LV wall thicknesses in 16 segments, both manually using the Medis Suite QMass program and automatically with the new OptiLayer method, which enables high-density sampling across the distance between the epicardial and endocardial contours. <b>Results:</b> The results showed that the segmental wall thickness measurement values of the OptiLayer algorithm were significantly higher than those of the manual caliper. In comparisons of the HEALTHY and LVET subgroups, OptiLayer measurements demonstrated differences at several points than manual measurements. Between the investigators, manual measurements showed low intraclass correlations (ICC below 0.6 on average), while measurements with OptiLayer gave excellent agreement (ICC above 0.9 in 75% of segments). <b>Conclusions:</b> Our study suggests that OptiLayer, a new automated wall thickness measurement software based on high-precision anatomical segmentation, offers a faster, more accurate, and more reproducible alternative to manual measurements.