Quantification of myocardial strain assessed by cardiovascular magnetic resonance feature tracking in healthy subjects-influence of segmentation and analysis software.

ABSTRACT

OBJECTIVES: Quantification of myocardial deformation by feature tracking is of growing interest in cardiovascular magnetic resonance. It allows the assessment of regional myocardial function based on cine images. However, image acquisition, post-processing, and interpretation are not standardized. We aimed to assess the influence of segmentation procedure such as slice selection and different types of analysis software on values and quantification of myocardial strain in healthy adults. METHODS: Healthy volunteers were retrospectively analyzed. Post-processing was performed using CVI42 and TomTec. Longitudinal and radialLong axis (LAX) strain were quantified using 4-chamber-view, 3-chamber-view, and 2-chamber-view. Circumferential and radialShort axis (SAX) strain were assessed in basal, midventricular, and apical short-axis views and using full coverage. Global and segmental strain values were compared to each other regarding their post-processing approach and analysis software package. RESULTS: We screened healthy volunteers studied at 1.5 or 3.0 T and included 67 (age 44.3 ± 16.3 years, 31 females). Circumferential and radialSAX strain values were different between a full coverage approach vs. three short slices (- 17.6 ± 1.8% vs. - 19.2 ± 2.3% and 29.1 ± 4.8% vs. 34.6 ± 7.1%). Different analysis software calculated significantly different strain values. Within the same vendor, different field strengths (- 17.0 ± 2.1% at 1.5 T vs. - 17.0 ± 1.7% at 3 T, p = 0.845) did not influence the calculated global longitudinal strain (GLS), and were similar in gender (- 17.4 ± 2.0% in females vs. - 16.6 ± 1.8% in males, p = 0.098). Circumferential and radial strain were different in females and males (circumferential strain - 18.2 ± 1.7% vs. - 17.1 ± 1.8%, p = 0.029 and radial strain 30.7 ± 4.7% vs. 27.8 ± 4.6%, p = 0.047). CONCLUSIONS: Myocardial deformation assessed by feature tracking depends on segmentation procedure and type of analysis software. CircumferentialSAX and radialSAX depend on the number of slices used for feature tracking analysis. As known from other imaging modalities, GLS seems to be the most stable parameter. During follow-up studies, standardized conditions should be warranted. Trial registration Retrospectively registered KEY POINTS • Myocardial deformation assessed by feature tracking depends on the segmentation procedure. • Global myocardial strain values differ significantly among vendors. • Standardization in post-processing using CMR feature tracking is essential.