A comparison of the reproducibility of two cine-derived strain software programmes in disease states

• Published in: European journal of radiology Vol. 113; pp. 51 - 58
• Main Authors: Graham-Brown, M.P., Gulsin, G.S., Parke, K., Wormleighton, J., Lai, F.Y., Athithan, L., Arnold, J.R., Burton, J.O., McCann, G.P., Singh, A.S.
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.04.2019
• Subjects: Aged; Aortic stenosis; Aortic Valve Stenosis - diagnosis; Aortic Valve Stenosis - physiopathology; Diabetes; Dialysis; Female; Humans; Magnetic Resonance Angiography - methods; Magnetic Resonance Imaging, Cine - methods; Male; Middle Aged; Prospective Studies; Reproducibility; Reproducibility of Results; Software; Strain; Stress, Physiological - physiology; Stroke Volume - physiology; Aortic stenosis; Dialysis; Diabetes; Reproducibility; Strain
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2019.01.026

•Tissue Tracking (TT) had superior test-retest reproducibility of peak early diastolic strain rates than Feature Tracking (FT) across diseases.•Reproducibility of systolic strain is excellent with FT and TT software in patients with diabetes, aortic stenosis and on haemodialysis.•Inter-observer variability for assessment of systolic strain and peak early diastolic strain rates are excellent for both FT and TT software.•Disease specific standard deviations and CoV of strain measures must be determined to allow appropriate power calculations for clinical studies. Systolic strain and peak-early diastolic strain rate (PEDSR) measure subclinical cardiac dysfunction. These parameters can be derived from cardiovascular magnetic resonance (CMR) cine images using new software packages, but the comparative test-retest reproducibility of these software in disease states is unknown. This study compared the test-retest reproducibility of strain measures derived from two software packages (feature-tracking software (FT) and tissue-tracking (TT)) in disease populations with preserved ejection fractions. This was a prospective study of 10 patients with aortic stenosis (AS), 10 haemodialysis patients and 10 diabetic patients at 1.5 and 3-Tesla. 30 subjects underwent test-retest reproducibility scans of global circumferential strain (GCS), global longitudinal strain (GLS), circumferential-PEDSR and longitudinal-PEDSR calculated using TT and FT software. Test-retest reproducibility of GCS and GLS were similar for FT and TT across patient groups. Coefficient of variability (CoV) for FT-derived GCS 8.1%, 5% and 7.9% for AS, diabetic and haemodialysis patients, compared to 3.3%, 9.2% and 5.4% for TT-derived GCS, with CoV for FT-derived GLS 8%, 6.4% and 8.2% for AS, diabetic and haemodialysis patients, compared to 5.3%, 4.8% and 7% for TT-derived GLS). Reproducibility of FT-derived circumferential and longitudinal-PEDSR was worse than TT-derived circumferential and longitudinal-PEDSR (CoV for FT-derived circumferential-PEDSR 18.2%, 18% and 17.4% for AS, diabetic and haemodialysis patients, compared to 6.1%, 11.7% and 11% for TT-derived circumferential-PEDSR with CoV for FT-derived longitudinal PEDSR 18.2%, 18.9%, 18.3% for AS, diabetic and haemodialysis patients, compared to 8.9%, 9.1% and 11.4% for TT-derived longitudinal-PEDSR). Bland-Altman analysis revealed no systematic bias with tighter limits of agreement for TT-derived strain measures. Reproducibility of GCS and GLS are excellent with FT and TT software across diseases. TT had superior test-retest reproducibility for quantification of longitudinal and circumferential-PEDSR than FT-derived PEDSR across diseases.