Comparison of manual and artificial intelligence based quantification of myocardial strain by feature tracking—a cardiovascular MR study in health and disease

Abstract

Objectives The analysis of myocardial deformation using feature tracking in cardiovascular MR allows for the assessment of global and segmental strain values. The aim of this study was to compare strain values derived from artificial intelligence (AI)–based contours with manually derived strain values in healthy volunteers and patients with cardiac pathologies. Materials and methods A cohort of 136 subjects (60 healthy volunteers and 76 patients; of those including 46 cases with left ventricular hypertrophy (LVH) of varying etiology and 30 cases with chronic myocardial infarction) was analyzed. Comparisons were based on quantitative strain analysis and on a geometric level by the Dice similarity coefficient (DSC) of the segmentations. Strain quantification was performed in 3 long-axis slices and short-axis (SAX) stack with epi- and endocardial contours in end-diastole. AI contours were checked for plausibility and potential errors in the tracking algorithm. Results AI-derived strain values overestimated radial strain (+ 1.8 ± 1.7% (mean difference ± standard deviation); p = 0.03) and underestimated circumferential (− 0.8 ± 0.8%; p = 0.02) and longitudinal strain (− 0.1 ± 0.8%; p = 0.54). Pairwise group comparisons revealed no significant differences for global strain. The DSC showed good agreement for healthy volunteers (85.3 ± 10.3% for SAX) and patients (80.8 ± 9.6% for SAX). In 27 cases (27/76; 35.5%), a tracking error was found, predominantly (24/27; 88.9%) in the LVH group and 22 of those (22/27; 81.5%) at the insertion of the papillary muscle in lateral segments. Conclusions Strain analysis based on AI-segmented images shows good results in healthy volunteers and in most of the patient groups. Hypertrophied ventricles remain a challenge for contouring and feature tracking. Clinical relevance statement AI-based segmentations can help to streamline and standardize strain analysis by feature tracking. Key Points • Assessment of strain in cardiovascular magnetic resonance by feature tracking can generate global and segmental strain values. • Commercially available artificial intelligence algorithms provide segmentation for strain analysis comparable to manual segmentation. • Hypertrophied ventricles are challenging in regards of strain analysis by feature tracking.

Reference ranges of computed tomography-derived strains in four cardiac chambers

“…Further validations with larger cohorts and comparison with other software and modalities are of value. Additionally, the recent integration of artificial intelligence in CMR strain measurement [ 39 ] suggests a similar potential for CT strain analysis. This approach could reduce interobserver variability and streamline the process, enhancing the practicality of CT strain in clinical use.…”

Trajectories of functional and structural myocardial parameters in post-COVID-19 syndrome—insights from mid-term follow-up by cardiovascular magnetic resonance

“…Left atrial function was assessed biplanar using the two- and four- chamber views. Strain analysis was carried out with retrospective feature tracking on cine images as reported recently ( 21 ). Global values for longitudinal, radial, and circumferential strain are reported.…”

Artificial Intelligence in Heart Failure: Friend or Foe?

“…According to the results, the AI-derived strain values performed well in healthy volunteer images and most patient groups with an overestimation of radial strain and underestimation of circumferential and longitudinal strain. The above research demonstrated that utilizing AI-generated contours for feature tracking and strain analysis in cardiac magnetic resonance (CMR) produces results that are on par with manual segmentations [58]. It is crucial to exercise caution when assessing cases of left ventricle hypertrophy, particularly in patients with aortic stenosis, regardless of whether manual or AI-generated contours are employed.…”