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. 2019 Apr 25;1(1):e180005.
doi: 10.1148/ryct.2019180005. eCollection 2019 Apr.

Reproducibility and Agreement of Tissue Tracking versus Feature Tracking for Strain Measurement on Cardiac MR Images in Patients with Repaired Tetralogy of Fallot

Jimmy C Lu  1 , Sowmya Balasubramanian  1 , Sunkyung Yu  1 , Maryam Ghadimi Mahani  1 , Prachi P Agarwal  1 , Adam L Dorfman  1
Affiliations

Reproducibility and Agreement of Tissue Tracking versus Feature Tracking for Strain Measurement on Cardiac MR Images in Patients with Repaired Tetralogy of Fallot

Jimmy C Lu et al. Radiol Cardiothorac Imaging. .

Abstract

Purpose: To evaluate differences in strain measurements by using tissue-tracking (TT) and feature-tracking (FT) software on cardiovascular MR images in patients with repaired tetralogy of Fallot (TOF).

Materials and methods: In this retrospective cross-sectional study of 25 patients with repaired TOF (median age, 33.1 years; interquartile range, 25.3-38.3 years) from 2008 through 2014, left ventricular (LV) and right ventricular (RV) global circumferential and longitudinal strain were measured from cardiac MR images by using TT and FT software. Time to process was measured from opening the study to acceptance of contours. Intra- and interobserver reproducibility were evaluated with Bland-Altman analysis, coefficient of variation, and intraclass correlation coefficient.

Results: Time to process was slightly longer for TT (10.2 minutes ± 3.1 [standard deviation] vs 9.0 minutes ± 1.7, P = .04). Fewer patients required contour revision with TT than with FT. Both TT and FT measurements had similar moderate-to-strong correlations with LV and RV ejection fractions; correlation of RV longitudinal strain with RV ejection fraction did not reach significance by using either method. With the exception of LV circumferential strain, strain measurements were lower with FT relative to TT. Intra- and interobserver reproducibility were lower with FT for longitudinal strain measurements.

Conclusion: TT and FT have systematic differences in strain values and reproducibility, particularly for longitudinal strain. Software-specific normative data are necessary, as are studies to evaluate correlation with clinical outcomes for each modality.© RSNA, 2019.

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Conflict of interest statement

Disclosures of Conflicts of Interest: J.C.L. disclosed no relevant relationships. S.B. disclosed no relevant relationships. S.Y. disclosed no relevant relationships. M.G.M. disclosed no relevant relationships. P.P.A. Activities related to the present article: disclosed no relevant relationships. Activities not related to the present article: employed by Michigan Medicine. Other relationships: disclosed no relevant relationships. A.L.D. disclosed no relevant relationships.

Figures

Figure 1a:
Figure 1a:
Feature-tracking contours for the left ventricle were drawn on three short-axis sections and single two-chamber, three-chamber, and four-chamber views. Feature-tracking contours for the right ventricle were drawn on a single short-axis section and a single four-chamber view. A representative (a) short-axis MR section and (b) four-chamber MR section show feature-tracking contours (green lines).
Figure 1b:
Figure 1b:
Feature-tracking contours for the left ventricle were drawn on three short-axis sections and single two-chamber, three-chamber, and four-chamber views. Feature-tracking contours for the right ventricle were drawn on a single short-axis section and a single four-chamber view. A representative (a) short-axis MR section and (b) four-chamber MR section show feature-tracking contours (green lines).
Figure 2a:
Figure 2a:
Tissue-tracking contours for the left ventricle were drawn on all short-axis sections and all available two-chamber, three-chamber, and four-chamber views. A representative (a) short-axis MR section and (b) four-chamber MR section show tissue-tracking contours (colored lines). Tissue-tracking contours for the right ventricle were drawn on all available short-axis sections and four-chamber views. The annulus and apex were identified on long-axis images, and superior and inferior septal insertion points were identified on short-axis images.
Figure 2b:
Figure 2b:
Tissue-tracking contours for the left ventricle were drawn on all short-axis sections and all available two-chamber, three-chamber, and four-chamber views. A representative (a) short-axis MR section and (b) four-chamber MR section show tissue-tracking contours (colored lines). Tissue-tracking contours for the right ventricle were drawn on all available short-axis sections and four-chamber views. The annulus and apex were identified on long-axis images, and superior and inferior septal insertion points were identified on short-axis images.
Figure 3:
Figure 3:
Graph shows strain values for left ventricular (LV) and right ventricular (RV) global circumferential strain (GCS) or global longitudinal strain (GLS). Data are presented for tissue tracking (TT) using global measurements or endocardial strain on the same section as feature tracking (TT endo) and for feature tracking (FT). Whiskers = standard deviation.
Figure 4:
Figure 4:
Bland-Altman plot of intraobserver variability for tissue tracking and feature tracking. The x-axis is the average value, and the y-axis is the difference between tissue tracking and feature tracking. The mean difference and limits of agreement are denoted by the solid and dashed lines, respectively. Values are percentages. GCS = global circumferential strain, GLS = global longitudinal strain, LV = left ventricle, RV = right ventricle.
Figure 5:
Figure 5:
Bland-Altman plot of interobserver variability for tissue tracking and feature tracking. The x-axis is the average value, and the y-axis is the difference between tissue tracking and feature tracking. The mean difference and limits of agreement are denoted by the solid and dashed lines, respectively. Values are percentages. GCS = global circumferential strain, GLS = global longitudinal strain, LV = left ventricle, RV = right ventricle.
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