Feature tracking compared with tissue tagging measurements of segmental strain by cardiovascular magnetic resonance

Abstract

BackgroundLeft ventricular segmental wall motion analysis is important for clinical decision making in cardiac diseases. Strain analysis with myocardial tissue tagging is the non-invasive gold standard for quantitative assessment, however, it is time-consuming. Cardiovascular magnetic resonance myocardial feature-tracking (CMR-FT) can rapidly perform strain analysis, because it can be employed with standard CMR cine-imaging. The aim is to validate segmental peak systolic circumferential strain (peak SCS) and time to peak systolic circumferential strain (T2P-SCS) analysed by CMR-FT against tissue tagging, and determine its intra and inter-observer variability.MethodsPatients in whom both cine CMR and tissue tagging has been performed were selected. CMR-FT analysis was done using endocardial (CMR-FTendo) and mid-wall contours (CMR-FTmid). The Intra Class Correlation Coefficient (ICC) and Pearson correlation were calculated.Results10 healthy volunteers, 10 left bundle branch block (LBBB) and 10 hypertrophic cardiomyopathy patients were selected. With CMR-FT all 480 segments were analyzable and with tissue tagging 464 segments.Significant differences in mean peak SCS values of the total study group were present between CMR-FTendo and tissue tagging (-23.8 ± 9.9% vs -13.4 ± 3.3%, p < 0.001). Differences were smaller between CMR-FTmid and tissue tagging (-16.4 ± 6.1% vs -13.4 ± 3.3%, p = 0.001). The ICC of the mean peak SCS of the total study group between CMR-FTendo and tissue tagging was low (0.19 (95%-CI-0.10-0.49), p = 0.02). Comparable results were seen between CMR-FTmid and tissue tagging. In LBBB patients, mean T2P-SCS values measured with CMR-FTendo and CMR-FTmid were 418 ± 66 ms, 454 ± 60 ms, which were longer than with tissue tagging, 376 ± 55 ms, both p < 0.05. ICC of the mean T2P-SCS between CMR-FTendo and tissue tagging was 0.64 (95%-CI-0.36-0.81), p < 0.001, this was better in the healthy volunteers and LBBB group, whereas the ICC between CMR-FTmid and tissue tagging was lower.The intra and inter-observer agreement of segmental peak SCS with CMR-FTmid was lower compared with tissue tagging; similar results were seen for segmental T2P-SCS.ConclusionsThe intra and inter-observer agreement of segmental peak SCS and T2P-SCS is substantially lower with CMR-FTmid compared with tissue tagging. Therefore, current segmental CMR-FTmid techniques are not yet applicable for clinical and research purposes.

Cine dyscontractility index: A novel marker of mechanical dyssynchrony that predicts response to cardiac resynchronization therapy

“…Thus, expectedly and in line with prior literature, 21 both approaches provide linked but certainly nonidentical measures of strain. In our cohort, results were modestly correlated between the two methods on both a segmentotemporal and minimal strain in segment basis.…”

Reproducibility of cine displacement encoding with stimulated echoes (DENSE) in human subjects

“…However, data from animal studies may not fully predict the reliability of DENSE for describing myocardial motion patterns in human subjects. Actually, existing results of human studies on similar MRI techniques, such as traditional MRI tagging or feature tracking, were unable to show optimal inter-study reproducibility for strain and its related measurements in all myocardial planes in human subjects (11, 16). We thought this variability may originate from two major sources, image analysis and image acquisition.…”

Heart deformation analysis for automated quantification of cardiac function and regional myocardial motion patterns: A proof of concept study in patients with cardiomyopathy and healthy subjects

“…However, applying FT algorithms to clinical image data is challenging, as some features may change or disappear from time frame to time frame. As such, intra-, inter-observer and inter-study reproducibility of FT-derived myocardial strain measures are not high in healthy volunteers or clinical patients with left bundle branch block (LBBB) (14, 15). In addition, FT tracking needs a time consuming operation for manually tracing myocardial borders.…”