Key result
Segment software yields higher end-systolic rotation and torsion values than Harmonic Phase Flow software.
Why the study?
Several software packages have been developed to analyze left ventricular rotation and torsion, but the suitability of software using different technical principles needed comparison.
Does the choice of CMR tagging analysis software (Segment vs HPF) affect the calculated left ventricle rotation and torsion values in patients with and without HCM?
Cross-Sectional (n=36)
Yes
Does the choice of CMR tagging analysis software (Segment vs HPF) affect the calculated left ventricle rotation and torsion values in patients with and without HCM?
Software-specific reference values are required when analyzing CMR tagging for left ventricular rotation and torsion, as different software packages yield significantly different absolute values despite good correlation.
Answers are grounded in this paper and cite their sources.
CMR tagging software choice affects LV rotation and torsion values; leaves open whether software-specific norms are needed before clinical adoption.
Background Left ventricle rotation and torsion are fundamental components of myocardial function, and several software packages have been developed for analysis of these components. The purpose of this study was to compare the suitability of two software packages with different technical principles for analysis of rotation and torsion of the left ventricle during systole. Methods A group of hypertrophic cardiomyopathy (HCM) patients ( N = 14, age 43 ± 11 years), mutation carriers without hypertrophy ( N = 10, age 34 ± 13 years), and healthy relatives ( N = 12, age 43 ± 17 years) underwent a cardiovascular magnetic resonance examination, including spatial modulation of magnetization tagging sequences in basal and apical planes of the left ventricle. The tagging images were analyzed offline using a harmonic phase image analysis method with Gabor filtering and a non-rigid registration-based free-form deformation technique. Left-ventricle rotation and torsion scores were obtained from end-diastole to end-systole with both software. Results Analysis was successful in all cases with both software applications. End-systolic torsion values between the study groups were not statistically different with either software. End-systolic apical rotation, end-systolic basal rotation, and end-systolic torsion were consistently higher when analyzed with non-rigid registration than with harmonic phase-based analysis ( p < 0.0001). End-systolic rotation and torsion values had significant correlations between the two software ( p < 0.0001), most significant in the apical plane. Conclusions When comparing absolute values of rotation and torsion between different individuals, software-specific reference values are required. Harmonic phase flow with Gabor filtering and non-rigid registration-based methods can both be used reliably in the analysis of systolic rotation and torsion patterns of the left ventricle.
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Lehmonen et al. (2020) conducted a cross-sectional in Hypertrophic cardiomyopathy (n=36). Segment strain tagging module vs. Harmonic Phase Flow (HPF) plugin was evaluated on Absolute end-systolic rotation and torsion values (p=<0.0001). End-systolic apical rotation, basal rotation, and torsion values were higher when analyzed with Segment software compared to Harmonic Phase Flow software.
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