Ultrasound-Based Semi-Automated Software for Measuring Left Atrial Volume in Pediatric Echocardiography: Efficiency and Feasibility

Traditional left atrial volume (LAV) measurement typically requires manual tracing, which can be time-consuming, especially in a clinical setting with pediatric patients. Recently, semi-automated methods using 2D speckle tracking echocardiography (STE) and 3D echocardiography (3DE) have been developed to improve efficiency. This study aimed to evaluate the feasibility and efficiency of these semi-automated LAV measurement techniques in a pediatric population. A total of 207 pediatric echocardiographic images of the left atrium were analyzed, with LAV measurements conducted using three methods: (1) traditional manual tracing, (2) STE-based semi-automated measurement, and (3) 3DE-based semi-automated measurement. Time requirements and reproducibility were compared across these methods. On average, LAV measurement times were 32.6 ± 3.5 seconds for manual tracing, 53.8 ± 10.8 seconds for the STE-based technique, and 33.8 ± 13.0 seconds for the 3DE-based technique, showing that 3DE-based measurement times were comparable to manual tracing and faster than STE-based methods. In terms of LAV values, the 3DE-based measurements were slightly lower than those obtained via manual tracing, but these discrepancies were minor. Reproducibility testing showed consistent intra-observer agreement across all methods, while inter-observer reproducibility was notably better with the 3DE-based approach. This finding suggests that 3DE-based LAV measurement may offer enhanced reliability when measurements are performed by different observers, a useful advantage in clinical practice. Overall, while 3DE-based methods may yield slightly lower LAV measurements than manual tracing, their faster measurement times and superior inter-observer reproducibility make them a promising tool for routine pediatric echocardiography. Integration of 3DE-based semi-automated techniques into routine practice may streamline workflow without compromising accuracy, ultimately enhancing the efficiency of pediatric echocardiographic assessments.