Reproducibility and its confounders of CMR feature tracking myocardial strain analysis in patients with suspected myocarditis.

Fischer, Kady; Linder, Olivier L.; Erne, Sophie A.; Stark, Anselm W.; Obrist, Sarah J.; Bernhard, Benedikt; Guensch, Dominik P.; Huber, Adrian T.; Kwong, Raymond Y.; Gräni, Christoph (2022). Reproducibility and its confounders of CMR feature tracking myocardial strain analysis in patients with suspected myocarditis. European radiology, 32(5), pp. 3436-3446. Springer 10.1007/s00330-021-08416-5

[img]
Preview
Text
Reproducibility_Huber.pdf - Published Version
Available under License Creative Commons: Attribution (CC-BY).

Download (2MB) | Preview

OBJECTIVES

Cardiovascular magnetic resonance feature tracking (CMR-FT) is an emerging technique for assessing myocardial strain with valuable diagnostic and prognostic potential. However, the reproducibility of biventricular CMR-FT analysis in a large cardiovascular population has not been assessed. Also, evidence of confounders impacting reader reproducibility for CMR-FT in patients is unknown and currently limits the clinical implementation of this technique.

METHODS

From a dual-center database of patients referred to CMR for suspected myocarditis, 125 patients were randomly selected to undergo biventricular CMR-FT analysis for 2-dimensional systolic and diastolic measures, with additional 3-dimensional analysis for the left ventricle. All image analysis was replicated by a single reader and by a second reader for intra- and inter-reader analysis (Circle Cardiovascular Imaging). Reliability was tested with intraclass correlation (ICC) tests, and the impact of imaging confounders on agreement was assessed through multivariable analysis.

RESULTS

Left and right ventricular ejection fractions were reduced in 34% and 37% of the patients, respectively. Good to excellent reliability was shown for 2D (all ICC > 0.85) and 3D (all ICC > 0.70) peak strain and early diastolic strain rate for both ventricles in longitudinal orientation as well as circumferential orientations for the left ventricle. An increased slice number improved agreement while the presence of pericardial effusion compromised diastolic strain rate agreement, and arrhythmia compromised right ventricular agreement.

CONCLUSION

In a large clinical cohort, we could show CMR-FT yields excellent inter-reader and intra-reader reproducibility. Multi-parametric CMR-FT of the right and left ventricles appears to be a robust tool in cardiovascular patients referred to CMR.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT03470571, NCT04774549. Key Points • Cardiovascular magnetic resonance feature tracking (CMR-FT) is an emerging technique to measure myocardial strain in cardiovascular patients referred for CMR; however, the evaluation of its reproducibility in a large cohort has not yet been performed. • In a large clinical cohort, CMR-FT yields excellent inter-reader and intra-reader reproducibility for both left and right ventricular systolic and diastolic parameters. • Arrhythmia and pericardial effusion compromise agreement of select FT parameters, but poor ejection fraction does not.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Fischer, Kady Anne; Linder, Olivier Luca; Stark, Anselm Walter; Bernhard, Benedikt; Günsch, Dominik; Huber, Adrian Thomas and Gräni, Christoph

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1432-1084

Publisher:

Springer

Language:

English

Submitter:

Maria de Fatima Henriques Bernardo

Date Deposited:

29 Dec 2021 10:17

Last Modified:

27 Apr 2022 00:12

Publisher DOI:

10.1007/s00330-021-08416-5

PubMed ID:

34932165

Uncontrolled Keywords:

Magnetic resonance imaging Myocarditis Reproducibility of results Ventricular dysfunction

BORIS DOI:

10.48350/162956

URI:

https://boris.unibe.ch/id/eprint/162956

Actions (login required)

Edit item Edit item
Provide Feedback