Comparison of left ventricular strains and torsion derived from feature tracking and DENSE CMR

Cardiovascular magnetic resonance (CMR) feature tracking is increasingly used to quantify cardiac mechanics from cine CMR imaging, although validation against reference standard techniques has been limited. Furthermore, studies have suggested that commonly-derived metrics, such as peak global strain...

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Bibliographic Details
Published in:	Journal of cardiovascular magnetic resonance Vol. 20; no. 1; p. 63
Main Authors:	Wehner, Gregory J, Jing, Linyuan, Haggerty, Christopher M, Suever, Jonathan D, Chen, Jing, Hamlet, Sean M, Feindt, Jared A, Dimitri Mojsejenko, W, Fogel, Mark A, Fornwalt, Brandon K
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 13-09-2018 BioMed Central Elsevier
Subjects:	Adolescent Adult Agreements Bias Biomechanical Phenomena Cardiac function Child Circumferences Coefficient of variation Contours Databases, Factual DENSE Diastole Dyssynchrony Echoes Feature tracking Female Heart Humans Identification methods Image acquisition Image Interpretation, Computer-Assisted - methods Image Interpretation, Computer-Assisted - standards Image processing Kentucky Magnetic resonance Magnetic resonance imaging Magnetic Resonance Imaging, Cine - methods Magnetic Resonance Imaging, Cine - standards Male Mechanics Mechanics (physics) Myocardial Contraction NMR Nuclear magnetic resonance Philadelphia Predictive Value of Tests Reference Standards Reproducibility of Results Retrospective Studies Shape Software Strain Studies Systole Torsion Torsion, Mechanical Ventricle Ventricular Dysfunction, Left - diagnostic imaging Ventricular Dysfunction, Left - physiopathology Ventricular Function, Left Young Adult Philadelphia Kentucky DENSE Dyssynchrony Feature tracking Torsion Strain
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Summary:	Cardiovascular magnetic resonance (CMR) feature tracking is increasingly used to quantify cardiac mechanics from cine CMR imaging, although validation against reference standard techniques has been limited. Furthermore, studies have suggested that commonly-derived metrics, such as peak global strain (reported in 63% of feature tracking studies), can be quantified using contours from just two frames - end-diastole (ED) and end-systole (ES) - without requiring tracking software. We hypothesized that mechanics derived from feature tracking would not agree with those derived from a reference standard (displacement-encoding with stimulated echoes (DENSE) imaging), and that peak strain from feature tracking would agree with that derived using simple processing of only ED and ES contours. We retrospectively identified 88 participants with 186 pairs of DENSE and balanced steady state free precession (bSSFP) image slices acquired at the same locations across two institutions. Left ventricular (LV) strains, torsion, and dyssynchrony were quantified from both feature tracking (TomTec Imaging Systems, Circle Cardiovascular Imaging) and DENSE. Contour-based strains from bSSFP images were derived from ED and ES contours. Agreement was assessed with Bland-Altman analyses and coefficients of variation (CoV). All biases are reported in absolute percentage. Comparison results were similar for both vendor packages (TomTec and Circle), and thus only TomTec Imaging System data are reported in the abstract for simplicity. Compared to DENSE, mid-ventricular circumferential strain (Ecc) from feature tracking had acceptable agreement (bias: - 0.4%, p = 0.36, CoV: 11%). However, feature tracking significantly overestimated the magnitude of Ecc at the base (bias: - 4.0% absolute, p < 0.001, CoV: 18%) and apex (bias: - 2.4% absolute, p = 0.01, CoV: 15%), underestimated torsion (bias: - 1.4 deg/cm, p < 0.001, CoV: 41%), and overestimated dyssynchrony (bias: 26 ms, p < 0.001, CoV: 76%). Longitudinal strain (Ell) had borderline-acceptable agreement (bias: - 0.2%, p = 0.77, CoV: 19%). Contour-based strains had excellent agreement with feature tracking (biases: - 1.3-0.2%, CoVs: 3-7%). Compared to DENSE as a reference standard, feature tracking was inaccurate for quantification of apical and basal LV circumferential strains, longitudinal strain, torsion, and dyssynchrony. Feature tracking was only accurate for quantification of mid LV circumferential strain. Moreover, feature tracking is unnecessary for quantification of whole-slice strains (e.g. base, apex), since simplified processing of only ED and ES contours yields very similar results to those derived from feature tracking. Current feature tracking technology therefore has limited utility for quantification of cardiac mechanics.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Undefined-3
ISSN:	1097-6647 1532-429X
DOI:	10.1186/s12968-018-0485-4