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Left ventricular global myocardial strain assessment comparing the reproducibility of four commercially available CMR-feature tracking algorithms

  • Cardiac
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To compare the reproducibility of cardiovascular magnetic resonance feature-tracking (CMR-FT) packages to assess global left ventricular (LV) myocardial strain.

Methods

In 45 subjects (i.e. 15 controls, 15 acute myocardial infarction, 15 dilated cardiomyopathy patients), we determined inter-vendor, inter-observer (two readers) and intra-observer reproducibility of peak systolic global radial, circumferential and longitudinal strain (GRS, GCS and GLS, respectively) comparing four commercially available software packages. Differences between vendors were assessed with analysis of variance (ANOVA), between observers and readings with intraclass correlation coefficient (ICC) and coefficient of variation (CV).

Results

The normalised end-diastolic volume was 91, 77 and 119 ml/m2 (median, Q1, Q3) and ejection fraction was 41 ± 14%, range 12-67%. Global longitudinal strain (GLS), global circumferential strain (GCS) and global radial strain (GRS) values were 13.9% ± 5.4% (3.9-23.8%), 12.2% ± 5.8% (1.0-25.1%) and 32.0% ± 14.7 (3.6-67.8%), respectively. ANOVA showed significant differences between vendors for GRS (p < 0.001) and GLS (p = 0.018), not for GCS (p = 0.379). No significant bias was found for both intra- and inter-observer variability. The ICC for inter- and intra-observer reproducibility ranged 0.828-0.991 and 0.902-0.997, respectively. The CV, however, ranged considerably, i.e. 4.0-28.8% and 2.8- 27.7% for inter- and intra-observer reproducibility, respectively. In particular, for GRS differences in CV values between vendors were large, i.e. 5.2-28.8% and 2.8-27.7%, for inter- and intra-observer reproducibility, respectively.

Conclusions

In a cohort of subjects with a wide range of cardiac performances, GRS and GLS values are not interchangeable between vendors. Moreover, although intra- and inter-observer reproducibility amongst vendors is excellent, some vendors encounter problems to reproducibly measure global radial strain.

Key Points

• Different software packages are currently available for myocardial strain assessment using routinely acquired cine CMR images.

• Global myocardial strain values are not interchangeable between vendors for global longitudinal and global radial strain.

• Inter- and intra-observer reproducibility for global strain assessment is excellent. However, some vendors encounter problems to reproducibly measure global radial strain.

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Abbreviations

CMR:

Cardiovascular magnetic resonance

CV:

Coefficient of variation

DCM:

Dilated cardiomyopathy

EF:

Ejection fraction

FT:

Feature-tracking

GCS:

Global circumferential strain

GLS:

Global longitudinal strain

GRS:

Global radial strain

LV:

Left ventricle

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Funding

The authors state that this work has not received any funding.

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Author notes

  1. Barreiro-Pérez and Curione equally contributed to the manuscript.

Authors and Affiliations

  1. Department of Imaging and Pathology, KU Leuven – University of Leuven, Herestraat 49, 3000, Leuven, Belgium

    Manuel Barreiro-Pérez, Davide Curione, Rolf Symons & Jan Bogaert

  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

    Manuel Barreiro-Pérez

  3. Laboratory on Cardiovascular Imaging & Dynamics, Department of Cardiovascular Sciences, KU Leuven – University of Leuven, Herestraat 49, Leuven, Belgium

    Piet Claus

  4. Department of Cardiovascular Sciences, KU Leuven – University of Leuven, Herestraat 49, Leuven, Belgium

    Jens-Uwe Voigt

Authors
  1. Manuel Barreiro-Pérez
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  2. Davide Curione
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  3. Rolf Symons
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  4. Piet Claus
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  6. Jan Bogaert
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Corresponding author

Correspondence to Jan Bogaert.

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The scientific guarantor of this publication is Jan Bogaert

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

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Written informed consent was waived by the Institutional Review Board.

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• retrospective

• cross sectional study

• performed at one institution

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Barreiro-Pérez, M., Curione, D., Symons, R. et al. Left ventricular global myocardial strain assessment comparing the reproducibility of four commercially available CMR-feature tracking algorithms. Eur Radiol 28, 5137–5147 (2018). https://doi.org/10.1007/s00330-018-5538-4

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  • DOI: https://doi.org/10.1007/s00330-018-5538-4

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