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Left ventricular global myocardial strain assessment: Are CMR feature-tracking algorithms useful in the clinical setting?

  • CARDIAC RADIOLOGY
  • Published:
La radiologia medica Aims and scope Submit manuscript

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.

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Authors and Affiliations

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

    Palumbo Pierpaolo, Symons Rolf, Tom Dresselaers & 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

    Barreiro-Pérez Manuel

  3. Department of Radiology, Ospedale Bambin Jésu, Vatican City, Italy

    Curione Davide

  4. Lab on Cardiovascular Imaging & Dynamics, Department of Cardiovascular Sciences, KU Leuven – University of Leuven, Herestraat 49, Louvain, Belgium

    Piet Claus

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  1. Palumbo Pierpaolo
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  4. Curione Davide
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  7. Jan Bogaert
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Correspondence to Jan Bogaert.

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All authors declare no personal or professional conflicts of interest relating to any aspect of this study.

Ethical standards

This study was approved by the ethical committee of the hospital. Because of the retrospective nature, informed patient consent was waived.

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Pierpaolo, P., Rolf, S., Manuel, BP. et al. Left ventricular global myocardial strain assessment: Are CMR feature-tracking algorithms useful in the clinical setting?. Radiol med 125, 444–450 (2020). https://doi.org/10.1007/s11547-020-01159-1

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  • DOI: https://doi.org/10.1007/s11547-020-01159-1

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