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Segmentation of the left atrium (LA) of the heart allows quantification of LA volume dynamics which can give insight into cardiac function. However, very little attention has been given to LA segmentation from three-dimensional (3-D) ultrasound (US), most efforts being focused on the segmentation of the left ventricle (LV). The B-spline explicit active surfaces (BEAS) framework has been shown to be a very robust and efficient methodology to perform LV segmentation. In this study, we propose an extension of the BEAS framework, introducing B-splines with uncoupled scaling. This formulation improves the shape support for less regular and more variable structures, by giving independent control over smoothness and number of control points. Semiautomatic segmentation of the LA endocardium using this framework was tested in a setup requiring little user input, on 20 volumetric sequences of echocardiographic data from healthy subjects. The segmentation results were evaluated against manual reference delineations of the LA. Relevant LA morphological and functional parameters were derived from the segmented surfaces, in order to assess the performance of the proposed method on its clinical usage. The results showed that the modified BEAS framework is capable of accurate semiautomatic LA segmentation in 3-D transthoracic US, providing reliable quantification of the LA morphology and function. [ABSTRACT FROM PUBLISHER]