VentricularTools provides a streamlined workflow that allows you to calculate ventricular volume, mass and ejection fraction accurately in a matter of minutes. The workflow is divided into the following 6 simple steps.
VentricularTools workflow
Step 1 - Select images 
The first step of the VentricularTools workflow allows you to select which images are to be used in your study. You will need a set of parallel short axis cine images that provide complete coverage of the left ventricle. You will also need 2 long axis images that pass through the mitral valve. Example images are provided to help you to get started.
Step 2 - Identify end-diastole and end-systole
The second step requires you to identify end-diastole and end-systole in a mid ventricular short axis cine image. These are the 2 time points for which a 3D model of the ventricle will be constructed. It is important to select these timepoints so that they exhibit the maximum and minimum volume of the ventricular blood pool respectively.
Step 3 - Locate apex
This step allows you to locate the apex in 4 different long axis views of the ventricle. This information is used to constrain a 3D segmentation algorithm that automatically delineates the epicardial and endocardial surfaces of the ventricle.
Step 4 - Draw valve plane
The base of the ventricle can move significantly over the cardiac cycle. When calculating the volumetric properties of the ventricle it is therefore necessary to track its boundary with the left atrium. VentricularTools allows you to define a plane that delineates this boundary by identifying landmark points in 2 long axis views.
Step 5 - Review contours
VentricularTools utilises a model fitting algorithm to provide an initial segmentation of the epicardial border. It is possible to compensate for errors in segmentation with a manual correction facility. The endocardial border is segmented using an automatic Gaussian Mixture Model that classifies pixels as belong to blood or myocardium.
Step 6 View results
Once you are sure that the left ventricle is correctly delineated, you should progress onto the final step that presents the calculated volume, mass and ejection fraction. The results can be export to a third party spreadsheet for further analysis.