Head-to-Head Comparison of Global and Regional Two-Dimensional Speckle Tracking Strain Versus Cardiac Magnetic Resonance Tagging in a Multicenter Validation Study

Amzulescu, Mihaela Silvia; Langet, Hélène; Saloux, Éric; Manrique, Alain; Boileau, Laurianne; Slimani, Alisson; Allain, Philippe; Roy, Clotilde; Meester, Christophe de; Pasquet, Agnès; Craene, Mathieu De; Vancraeynest, David; Pouleur, Anne‐Catherine; Vanoverschelde, Jean-Louis J.; Gerber, Bernhard

doi:10.1161/circimaging.117.006530

Cited by 54 publications

(38 citation statements)

References 26 publications

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“…It has been shown that strain, determined using either echocardiography or CMR, is a valuable parameter to determine the impact of coronary artery disease on heart function [12], to detect LV dysfunction, especially in patients with heart failure when EF is still preserved [1,4,12,23] and to reveal diffuse damage to the myocardium due to systemic diseases, such as cardiac amyloidosis [24,25], sarcoidosis [26] or cardiotoxic effects of chemotherapy [5]. Despite these many possible indications, the use of strain in clinical routine is still challenging due to the impact of intra-, interobserver- [7] and inter-vendor reproducibility of the different post-processing platforms [8,9,27] on strain results, which could also explain the lack of inter-technique agreement between echocardiography and CMR [28]. Therefore, before conducting studies to validate strain techniques in large patient cohorts, it is important to (1) identify the possible factors influencing strain results and to (2) minimize the impact of these factors.…”

Section: Discussionmentioning

confidence: 99%

A multi-vendor, multi-center study on reproducibility and comparability of fast strain-encoded cardiovascular magnetic resonance imaging

Erley

Zieschang

Lapinskas

et al. 2020

Int J Cardiovasc Imaging

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Myocardial strain is a convenient parameter to quantify left ventricular (LV) function. Fast strain-encoding (fSENC) enables the acquisition of cardiovascular magnetic resonance images for strain-measurement within a few heartbeats during free-breathing. It is necessary to analyze inter-vendor agreement of techniques to determine strain, such as fSENC, in order to compare existing studies and plan multi-center studies. Therefore, the aim of this study was to investigate inter-vendor agreement and test-retest reproducibility of fSENC for three major MRI-vendors. fSENC-images were acquired three times in the same group of 15 healthy volunteers using 3 Tesla scanners from three different vendors: at the German Heart Institute Berlin, the Charité University Medicine Berlin-Campus Buch and the Theresien-Hospital Mannheim. Volunteers were scanned using the same imaging protocol composed of two fSENC-acquisitions, a 15-min break and another two fSENCacquisitions. LV global longitudinal and circumferential strain (GLS, GCS) were analyzed by a trained observer (Myostrain 5.0, Myocardial Solutions) and for nine volunteers repeatedly by another observer. Inter-vendor agreement was determined using Bland-Altman analysis. Test-retest reproducibility and intra-and inter-observer reproducibility were analyzed using intraclass correlation coefficient (ICC) and coefficients of variation (CoV). Inter-vendor agreement between all three sites was good for GLS and GCS, with biases of 0.01-1.88%. Test-retest reproducibility of scans before and after the break was high, shown by ICC-and CoV values of 0.63-0.97 and 3-9% for GLS and 0.69-0.82 and 4-7% for GCS, respectively. Intra-and inter-observer reproducibility were excellent for both parameters (ICC of 0.77-0.99, CoV of 2-5%). This trial demonstrates good inter-vendor agreement and test-retest reproducibility of GLS and GCS measurements, acquired at three different scanners from three different vendors using fSENC. The results indicate that it is necessary to account for a possible bias (< 2%) when comparing strain measurements of different scanners. Technical differences between scanners, which impact inter-vendor agreement, should be further analyzed and minimized.

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Section: Discussionmentioning

confidence: 99%

A multi-vendor, multi-center study on reproducibility and comparability of fast strain-encoded cardiovascular magnetic resonance imaging

Erley

Zieschang

Lapinskas

et al. 2020

Int J Cardiovasc Imaging

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“…Furthermore, as opposed to speckle tracking, which also demonstrates excellent intra-observer and interobserver variability especially for GLS, 37 and tagging, validity of CMR FT has not been compared with phantom or animal work using the reference standard of sonomicrometry. 38 Despite the limitations of FT intervendor agreements, [16][17][18] the use of FT on bSSFP images is not subject to variability caused by different scanners or field strengths. 13 Noteworthy, this does not prove true for other quantification methods, such as native mapping techniques, which do not require specific reference values for software solutions available as in CMR-FT, but rather require them for each scanner and sequence.…”

Section: Agreementmentioning

confidence: 99%

“…13 One potential limitation is the lack of phantom or animal work using sonomicrometry as a basic science reference for deformation imaging validation; however, previous studies have reported good agreement of tagging with sonomicrometry. 38 Agreements were calculated for intertechnology and intervendor agreement on an intra-observer level, in the absence of interobserver agreement testing. However, analyses were performed by an experienced investigator in a core laboratory with previously shown high reproducibility also on the interobserver level.…”

Section: Study Limitationsmentioning

confidence: 99%

Head‐to‐head comparison of cardiovascular MR feature tracking cine versus acquisition‐based deformation strain imaging using myocardial tagging and strain encoding

Backhaus

Metschies

Zieschang

et al. 2020

Magnetic Resonance in Med

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Myocardial feature-tracking (FT) deformation imaging is superior for risk stratification compared with volumetric approaches. Because there is no clear recommendation regarding FT postprocessing, we compared different FT-strain analyses with reference standard techniques, including tagging and strain-encoded (SENC) MRI. Methods: Feature-tracking software from four different vendors (TomTec, Medis, Circle [CVI], and Neosoft), tagging (Segment), and fastSENC (MyoStrain) were used to determine left ventricular global circumferential strains (GCS) and longitudinal strains (GLS) in 12 healthy volunteers and 12 patients with heart failure. Variability and agreements were assessed using intraclass correlation coefficients for absolute agreement (ICCa) and consistency (ICCc) as well as Pearson correlation coefficients. Results: For FT-GCS, consistency was excellent comparing different FT vendors

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“…RV strain and strain rate values were initially evaluated using myocardial tagging technology (9). However, the laborious post-processing to extract and track the tagged lines on myocardium remains the major drawback of this tagging technology (10).…”

Section: Original Articlementioning

confidence: 99%

“…More recently, CMR cine image-based tissue tracking technology (CMR-TT) has allowed for a rapid and reliable quantification of myocardial deformation, with the advantage of high image quality unhindered by the availability of an adequate acoustic window (8)(9)(10). Normal ranges have been reported for left ventricular (LV) strain and strain rates using CMR-TT (8).…”

Section: Original Articlementioning

confidence: 99%

Age- and gender-related normal references of right ventricular strain values by tissue tracking cardiac magnetic resonance: results from a Chinese population

Liu¹,

Wang²,

Li³

et al. 2019

Quant. Imaging Med. Surg.

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Background: Myocardial deformation is a sensitive marker for sub-clinical myocardial dysfunction and carries independent prognostic significance across a broad range of cardiovascular diseases. Reproducible and repeatable assessment of right ventricular (RV) function is vital for monitoring congenital and acquired heart diseases. The purpose of this study was to determine the normal references of RV strain and strain rate values using tissue tracking cardiac magnetic resonance imaging (MRI). Methods: A cohort of 120 normal human subjects from each decade of life between 20 and 70 without cardiac diseases were enrolled in this study. Retrospectively, electrocardiogram (ECG) gating cardiac MRI imaging was performed at 3.0T with balanced steady-state free precession (bSSFP) imaging. RV global and segmental myocardial strains were analyzed by tissue tracking by two experienced observers. Results: The global peak longitudinal strain (GLS) and global peak radial strain (GRS) was −24.3±4.7 and 23.0±8.5 respectively. For the peak circumferential strains (GCS), the values for global, basal, mid-cavity, and apical segments were −13.3±4.1, −13.1±4.0, −12.5±4.7, and −15.9±5.8, respectively. There were significant gender differences in peak GRS (P=0.009) and at the base (P=0.017) and the mid-cavity (P=0.011) with greater deformation in females than in males. There were also significant age differences in GRS (P<0.001), GCS for basal (P<0.001), and mid-cavity segments (P=0.037). On Bland-Altman analysis, peak GLS and GRS had the best intra-observer agreement (mean bias, −0.13±0.51; 95% CI, −1.13-0.87) and inter-observer (mean bias, 0.054±0.31; 95% CI, −0.55-0.66) agreement, respectively. Conclusions: Normal values of RV deformation for healthy individuals using tissue tracking cardiac magnetic resonance (CMR-TT) provided good RV peak strain reproducibility. There was a significant correlation between RV strain or strain rate parameters with either age or sex.

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Head-to-Head Comparison of Global and Regional Two-Dimensional Speckle Tracking Strain Versus Cardiac Magnetic Resonance Tagging in a Multicenter Validation Study

Cited by 54 publications

References 26 publications

A multi-vendor, multi-center study on reproducibility and comparability of fast strain-encoded cardiovascular magnetic resonance imaging

A multi-vendor, multi-center study on reproducibility and comparability of fast strain-encoded cardiovascular magnetic resonance imaging

Head‐to‐head comparison of cardiovascular MR feature tracking cine versus acquisition‐based deformation strain imaging using myocardial tagging and strain encoding

Age- and gender-related normal references of right ventricular strain values by tissue tracking cardiac magnetic resonance: results from a Chinese population

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