Inter-vendor reproducibility of left and right ventricular cardiovascular magnetic resonance myocardial feature-tracking

Abstract

AimSince cardiovascular magnetic resonance feature-tracking (CMR-FT) has been demonstrated to be of incremental clinical merit we investigated the interchangeability of global left and right ventricular strain parameters between different CMR-FT software solutions.Material and methodsCMR-cine images of 10 patients without significant reduction in LVEF and RVEF and 10 patients with a significantly impaired systolic function were analyzed using two different types of FT-software (TomTec, Germany; QStrain, Netherlands). Global longitudinal strains (LV GLS, RV GLS), global left ventricular circumferential (GCS) and radial strains (GRS) were assessed. Differences in intra- and inter-observer variability within and between software types based on single and up to three repeated and subsequently averaged measurements were evaluated.ResultsInter-vendor agreement was highest for GCS followed by LV GLS. GRS and RV GLS showed lower inter-vendor agreement. Variability was consistently higher in healthy volunteers as compared to the patient group. Intra-vendor reproducibility was excellent for GCS, LV GLS and RV GLS, but lower for GRS. The impact of repeated measurements was most pronounced for GRS and RV GLS on an intra-vendor level.ConclusionCardiac pathology has no influence on CMR-FT reproducibility. LV GLS and GCS qualify as the most robust parameters within and between individual software types. Since both parameters can be interchangeably assessed with different software solutions they may enter the clinical arena for optimized diagnostic and prognostic evaluation of cardiovascular morbidity and mortality in various pathologies.

Validation of a rapid semi-automated method to assess left atrial longitudinal phasic strains on cine cardiovascular magnetic resonance imaging

“…Prior studies have investigated the impact of repeated measures on reproducibility of FT-CMR [ 43 , 44 ] where the differences in intra- and inter-observer variability were assessed based on single and averaged measurements (two and three repetitions with subsequent averaging of results, respectively). It was found that averaging of the results of repeated analyses improves the reproducibility of LA strain measurements.…”

“…In addition, inter-vendor comparisons have been performed in prior studies [ 43 , 44 , 46 ] to determine differences in strain measurements between commercially available FT-CMR software packages (TomTec, Medis QStrain and Circle Cardiovascular Imaging). The inter-vendor agreement was reasonably good for LV global circumferential strain and longitudinal strain, but was lower in right ventricular global longitudinal and radial strains [ 44 , 46 ]. The time for post-processing of a given case did not vary between the different types of software [ 43 ].…”

Head‐to‐head comparison of cardiovascular MR feature tracking cine versus acquisition‐based deformation strain imaging using myocardial tagging and strain encoding

“…Introduced in 2009, CMR feature tracking (FT) 12 is a postprocessing solution that is applied on routinely acquired balanced steady-state free precession (bSSFP) cine images with high blood-tissue contrast. Although CMR FT has been validated extensively, [13][14][15][16][17] significant concerns regarding intervendor agreement remain, leading to slow clinical implementation. 18 Furthermore, agreement with the reference standard for CMR-derived deformation assessment CMR tagging has been inconclusive, 19,20 with considerable dependence on observer experience.…”

“…Final strain values were calculated from the average of three repetitions. 16,17 The CMR tagging was performed on identical LV and short-axis slices using a triggered 2D TAG sequence generating an orthogonal saturation grid (grid spacing of 7 mm, tag grid angle of 45°). Typical parameters were as follows: FOV = 340 × 340 mm 2 , slice thickness = 8 mm, voxel size = 1.9 × 1.9 × 8 mm 3 , reconstructed solution = 1.2 × 1.2 × 8 mm 3 , flip angle = 15°, TE = 1.8 ms, and TR = 4.2 ms. Endocardial and epicardial borders were manually traced in end systole, which were then automatically propagated using a commercially available software (Segment version 2.2 R6960) for tagged image analyses ( Figure 1).…”

Quantitative Comparison of Two-dimensional and Three-dimensional Strain Measurement Using MRI Feature Tracking in Repair Fontan Patients and Normal Child Volunteers

“…In our study, the coefficient of variation of 3D GRS was not good (Figure 4). GRS represented strain throughout the entire myocardial wall from subepicardium to subendocardium and was consequently much more affected by through plane motion and complex diastolic and systolic twisting motion [29].…”