Palumbo Pierpaolo1, Symons Rolf1, Barreiro-Pérez Manuel2, Curione Davide3, Tom Dresselaers1, Piet Claus4, Jan Bogaert5. 1. Department of Imaging and Pathology, KU Leuven - University of Leuven, Herestraat 49, 3000, Leuven, Belgium. 2. Servicio de Cardiología, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, y CIBERCV, Salamanca, Spain. 3. Department of Radiology, Ospedale Bambin Jésu, Vatican City, Italy. 4. Lab on Cardiovascular Imaging & Dynamics, Department of Cardiovascular Sciences, KU Leuven - University of Leuven, Herestraat 49, Louvain, Belgium. 5. Department of Imaging and Pathology, KU Leuven - University of Leuven, Herestraat 49, 3000, Leuven, Belgium. jan.bogaert@uzleuven.be.
Abstract
OBJECTIVES: Myocardial strains can be calculated using cardiovascular magnetic resonance (CMR) feature-tracking (FT) algorithms. They show excellent intra- and inter-observer agreement but rather disappointing inter-vendor agreement. Currently, it is unknown how well CMR-FT-based strain values agree with manually obtained strain values. METHODS: In 45 subjects (15 controls, 15 acute myocardial infarction, 15 non-ischemic dilated cardiomyopathy), end-systolic manually derived strains were compared to four CMR-FT software packages. Global radial strain (GRS), global circumferential strain (GCS) and global longitudinal strain (GLS) were determined. Intra- and inter-observer agreement and agreement between manual and CMR-FT analysis were calculated. Statistical analysis included Bland-Altman plots, intra-class correlation coefficient (ICC) and coefficient of variation (CV). RESULTS: Manual contouring yielded excellent intra-observer (ICC 0.903 (GRS) to 0.995 (GCS)) and inter-observer agreement (ICC 0.915 (GRS) to 0.966 (GCS)) with CV ranging 4.7% (GCS) to 20.7% (GRS) and 12.7% (GCS) to 20.0% (GRS), for intra-observer and inter-observer agreement, respectively. Agreement between manual and CMR-FT strain values ranged from poor to excellent, with best agreement for GCS (ICC 0.857-0.935) and intermediate for GLS (ICC 0.591-0.914), while ICC values for GRS ranged widely (ICC 0.271-0.851). In particular, two software packages showed a strong trend toward systematic underestimation of myocardial strain in radial and longitudinal direction, correlating poorly to moderately with manual contouring, i.e., GRS (ICC 0.271, CV 25.2%) and GLS (ICC 0.591, CV 17.6%). CONCLUSION: Some CMR-FT values agree poorly with manually derived strains, emphasizing to be cautious to use these software packages in the clinical setting. In particular, radial and longitudinal strain tends to be underestimated when using manually derived strains as reference.
OBJECTIVES: Myocardial strains can be calculated using cardiovascular magnetic resonance (CMR) feature-tracking (FT) algorithms. They show excellent intra- and inter-observer agreement but rather disappointing inter-vendor agreement. Currently, it is unknown how well CMR-FT-based strain values agree with manually obtained strain values. METHODS: In 45 subjects (15 controls, 15 acute myocardial infarction, 15 non-ischemic dilated cardiomyopathy), end-systolic manually derived strains were compared to four CMR-FT software packages. Global radial strain (GRS), global circumferential strain (GCS) and global longitudinal strain (GLS) were determined. Intra- and inter-observer agreement and agreement between manual and CMR-FT analysis were calculated. Statistical analysis included Bland-Altman plots, intra-class correlation coefficient (ICC) and coefficient of variation (CV). RESULTS: Manual contouring yielded excellent intra-observer (ICC 0.903 (GRS) to 0.995 (GCS)) and inter-observer agreement (ICC 0.915 (GRS) to 0.966 (GCS)) with CV ranging 4.7% (GCS) to 20.7% (GRS) and 12.7% (GCS) to 20.0% (GRS), for intra-observer and inter-observer agreement, respectively. Agreement between manual and CMR-FT strain values ranged from poor to excellent, with best agreement for GCS (ICC 0.857-0.935) and intermediate for GLS (ICC 0.591-0.914), while ICC values for GRS ranged widely (ICC 0.271-0.851). In particular, two software packages showed a strong trend toward systematic underestimation of myocardial strain in radial and longitudinal direction, correlating poorly to moderately with manual contouring, i.e., GRS (ICC 0.271, CV 25.2%) and GLS (ICC 0.591, CV 17.6%). CONCLUSION: Some CMR-FT values agree poorly with manually derived strains, emphasizing to be cautious to use these software packages in the clinical setting. In particular, radial and longitudinal strain tends to be underestimated when using manually derived strains as reference.
Entities:
Keywords:
Function; Magnetic resonance imaging; Myocardium
Authors: Deborah Siry; Johannes Riffel; Janek Salatzki; Florian André; Lukas Damian Weberling; Marco Ochs; Noura A Atia; Elizabeth Hillier; David Albert; Hugo A Katus; Evangelos Giannitsis; Norbert Frey; Matthias G Friedrich Journal: BMC Med Imaging Date: 2022-09-05 Impact factor: 2.795