Inter-vendor reproducibility and accuracy of segmental left ventricular strain measurements using CMR feature tracking

Our aim was to evaluate the inter-vendor reproducibility of cardiovascular MR feature tracking (CMR-FT) for the measurement of segmental strain (SS) of the left ventricle (LV) as well as to test the accuracy of CMR-FT to detect regional myocardial pathology. We selected 45 patients: 15 with normal CMR findings, 15 with dilated cardiomyopathy, and 15 with acute myocardial infarction. Segmental longitudinal, circumferential, and radial strains were assessed with 4 different software. The inter-vendor difference as well as intra- and inter-observer variability was investigated. Furthermore, the accuracy of CMR-FT for the detection of structural (infarcted segments) as well as functional pathology (septal vs. lateral wall strain in left bundle branch block) was tested. Between vendors, there were significant differences in values for all strains (p < 0.001). The software using a non-rigid algorithm for image registration and segmentation demonstrated the best intra- as well as inter-observer variability with interclass correlation coefficient (ICC) > 0.962 and coefficient of variation (CV) < 24%. For infarct location, the same software yielded the highest area under the curve values for radial and circumferential SS (0.872 and 0.859, respectively). One of the other three software using optical flow technology performed best for longitudinal SS (0.799) and showed the largest differences in SS between septum and lateral wall in the dilated cardiomyopathy group. SS values obtained by CMR-FT are not interchangeable between vendors, and intra- and inter-observer reproducibility shows substantial variability among vendors. Overall, the different packages score relatively well to depict focal structural or functional LV pathology. • Segmental myocardial strain values obtained by CMR feature tracking are not interchangeable between different vendors. • Intra- and inter-observer reproducibility shows substantial variability among vendors. • Segmental myocardial strains measured by CMR feature tracking score relatively well to depict focal structural or functional LV pathology.

[1]  Petr Otahal,et al.  Prognostic implications of global LV dysfunction: a systematic review and meta-analysis of global longitudinal strain and ejection fraction , 2014, Heart.

[2]  David Maintz,et al.  Intra- and inter-observer reproducibility of global and regional magnetic resonance feature tracking derived strain parameters of the left and right ventricle. , 2017, European journal of radiology.

[3]  G. Lip,et al.  2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines:  The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC). , 2016, European heart journal.

[4]  R. Fimmers,et al.  Feature-tracking myocardial strain analysis in acute myocarditis: diagnostic value and association with myocardial oedema , 2017, European Radiology.

[5]  D. Woodrow Benson,et al.  Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking , 2011, Journal of visualized experiments : JoVE.

[6]  Jeroen J. Bax,et al.  2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines , 2016, European journal of heart failure.

[7]  P. Beerbaum,et al.  Cardiovascular Magnetic Resonance Myocardial Feature Tracking: Concepts and Clinical Applications , 2016, Circulation. Cardiovascular imaging.

[8]  E. Fleck,et al.  Value of additional strain analysis with feature tracking in dobutamine stress cardiovascular magnetic resonance for detecting coronary artery disease , 2014, Journal of Cardiovascular Magnetic Resonance.

[9]  M. Steinmetz,et al.  Cardiovascular magnetic resonance feature-tracking assessment of myocardial mechanics: Intervendor agreement and considerations regarding reproducibility , 2015, Clinical radiology.

[10]  Kazuaki Negishi,et al.  Intervendor variability of two-dimensional strain using vendor-specific and vendor-independent software. , 2015, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[11]  E. Donal,et al.  Global longitudinal strain as a major predictor of cardiac events in patients with depressed left ventricular function: a multicenter study. , 2010, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[12]  D. Maintz,et al.  Quantification of biventricular myocardial function using cardiac magnetic resonance feature tracking, endocardial border delineation and echocardiographic speckle tracking in patients with repaired tetralogy of fallot and healthy controls , 2012, Journal of Cardiovascular Magnetic Resonance.

[13]  Gerry P McCann,et al.  Comparison of cardiovascular magnetic resonance feature tracking and tagging for the assessment of left ventricular systolic strain in acute myocardial infarction. , 2015, European journal of radiology.

[14]  Hans Torp,et al.  Myocardial strain imaging: how useful is it in clinical decision making? , 2015, European heart journal.

[15]  Jens-Uwe Voigt,et al.  Intervendor Differences in the Accuracy of Detecting Regional Functional Abnormalities: A Report From the EACVI-ASE Strain Standardization Task Force. , 2017, JACC. Cardiovascular imaging.

[16]  Thomas H. Marwick,et al.  Prediction of All-Cause Mortality From Global Longitudinal Speckle Strain: Comparison With Ejection Fraction and Wall Motion Scoring , 2009, Circulation. Cardiovascular imaging.

[17]  J. Bogaert,et al.  Left ventricular global myocardial strain assessment comparing the reproducibility of four commercially available CMR-feature tracking algorithms , 2018, European Radiology.

[18]  Birgitta K. Velthuis,et al.  Feature tracking CMR reveals abnormal strain in preclinical arrhythmogenic right ventricular dysplasia/ cardiomyopathy: a multisoftware feasibility and clinical implementation study , 2017, Journal of Cardiovascular Magnetic Resonance.

[19]  J. Voigt,et al.  Head-to-Head Comparison of Global Longitudinal Strain Measurements among Nine Different Vendors: The EACVI/ASE Inter-Vendor Comparison Study. , 2015, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[20]  G. Pedrizzetti,et al.  Definitions for a common standard for 2D speckle tracking echocardiography: consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. , 2015, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[21]  M. Cerqueira,et al.  Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. , 2002, Circulation.

[22]  Jan D’hooge,et al.  Cardiovascular magnetic resonance myocardial feature tracking using a non-rigid, elastic image registration algorithm: assessment of variability in a real-life clinical setting , 2017, Journal of Cardiovascular Magnetic Resonance.

[23]  J. Voigt,et al.  Timing of myocardial shortening determines left ventricular regional myocardial work and regional remodelling in hearts with conduction delays , 2018, European heart journal cardiovascular Imaging.