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Strain measurement by cardiovascular magnetic resonance in pediatric cancer survivors: validation of feature tracking against harmonic phase imaging

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Abstract

Background

Left ventricular strain may be a more sensitive marker of left ventricular dysfunction than ejection fraction in pediatric cancer survivors after anthracycline therapy, but there is limited validation of strain measurement by feature tracking on cardiovascular magnetic resonance (MR) images.

Objective

To compare left ventricular circumferential and radial strain by feature tracking vs. harmonic phase imaging analysis (HARP) in pediatric cancer survivors.

Materials and methods

Twenty-six patients (20.2 ± 5.6 years old) underwent cardiovascular MR at least 5 years after completing anthracycline therapy. Circumferential and radial strain were measured at the base, midventricle and apex from short-axis myocardial tagged images by HARP, and from steady-state free precession images by feature tracking.

Results

Left ventricular ejection fraction more closely correlated with global circumferential strain by feature tracking (r = −0.63, P = 0.0005) than by HARP (r = −0.39, P = 0.05). Midventricular circumferential strain did not significantly differ by feature tracking or HARP (−20.8 ± 3.4 vs. −19.5 ± 2.5, P = 0.07), with acceptable limits of agreement. Midventricular circumferential strain by feature tracking strongly correlated with global circumferential strain by feature tracking (r = 0.87, P < 0.0001). Radial strain by feature tracking had poor agreement with HARP, particularly at higher values of radial strain. Intraobserver and interobserver reproducibility was excellent for feature tracking circumferential strain, but reproducibility was poor for feature tracking radial strain.

Conclusion

Midventricular circumferential strain by feature tracking is a reliable and reproducible measure of myocardial deformation in patients status post anthracycline therapy, while radial strain measurements are unreliable. Further studies are necessary to evaluate potential relation to long-term outcomes.

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Acknowledgment

This study was supported by the Cancer Director’s Research Fund, through the University of Michigan Comprehensive Cancer Center.

Conflicts of interest

None.

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Authors and Affiliations

  1. University of Michigan Congenital Heart Center, C.S. Mott Children’s Hospital, 1540 E. Hospital Drive, Ann Arbor, MI, 48109-4204, USA

    Jimmy C. Lu

  2. Department of Pediatrics and Communicable Diseases, Division of Pediatric Cardiology, University of Michigan, Ann Arbor, MI, USA

    Jimmy C. Lu & Adam L. Dorfman

  3. Department of Radiology, Section of Pediatric Radiology, University of Michigan, Ann Arbor, MI, USA

    Jimmy C. Lu & Adam L. Dorfman

  4. Department of Pediatrics and Communicable Diseases, Division of Hematology-Oncology, University of Michigan, Ann Arbor, MI, USA

    James A. Connelly

  5. Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA

    Lili Zhao

  6. Department of Radiology, Division of Cardiothoracic Radiology, University of Michigan, Ann Arbor, MI, USA

    Prachi P. Agarwal

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  1. Jimmy C. Lu
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  2. James A. Connelly
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  3. Lili Zhao
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  4. Prachi P. Agarwal
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  5. Adam L. Dorfman
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Correspondence to Jimmy C. Lu.

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Lu, J.C., Connelly, J.A., Zhao, L. et al. Strain measurement by cardiovascular magnetic resonance in pediatric cancer survivors: validation of feature tracking against harmonic phase imaging. Pediatr Radiol 44, 1070–1076 (2014). https://doi.org/10.1007/s00247-014-2992-2

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  • DOI: https://doi.org/10.1007/s00247-014-2992-2

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