RF-based two-dimensional cardiac strain estimation: a validation study in a tissue-mimicking phantom.

Strain and strain rate imaging have been shown to be useful techniques for the assessment of cardiac function. However, one of the major problems of these techniques is their angle dependency. In order to overcome this problem, a new method for estimating the strain (rate) tensor had previously been proposed by our lab. The aim of this study was to validate this methodology in a phantom setup. A tubular thick-walled tissue-mimicking phantom was fixed in a water tank. Varying the intraluminal pressure resulted in a cyclic radial deformation. The 2D strain was calculated from the 2D velocity estimates, obtained from 2D radio frequency (RF) tracking using a 1D kernel. Additionally, ultrasonic microcrystals were implanted on the outer and inner walls of the tube in order to give an independent measurement of the instantaneous wall thickness. The two methods were compared by means of linear regression, the correlation coefficient, and Bland-Altman statistics. As expected, the strain estimates dominated by the azimuth velocity component were less accurate than the ones dominated by the axial velocity component. Correlation coefficients were found to be r = 0.78 for the former estimates and r = 0.83 was found for the latter. Given that the overall shape and timing of the 2D deformation were very accurate (r = 0.95 and r = 0.84), these results were within acceptable limits for clinical applications. The 2D RF-tracking using a 1D kernel thus allows for 2D, and therefore angle-independent, strain estimation.