Key result
The K-SAD speckle tracking algorithm yielded peak global longitudinal systolic strain values of -17.02%, -19.00%, and -19.72% at the basal, mid, and apical regions in 410 healthy subjects.
Why the study?
Does the K-SAD algorithm improve the accuracy and noise-robustness of left ventricle strain estimation compared to commercial products in healthy subjects and simulated data?
Does the K-SAD algorithm improve the accuracy and noise-robustness of left ventricle strain estimation compared to commercial products in healthy subjects and simulated data?
The K-SAD algorithm reduces sensitivity to speckle noise and enhances accuracy in left ventricle strain estimation by using an integrated physiologically constrained optimization process.
K-SAD strain references in healthy subjects are hypothesis-generating; validation against commercial software needed before clinical adoption.
Speckle tracking echocardiography (STE) is a widespread method for calculating myocardial strains and estimating left ventricle function. Since echocardiographic clips are corrupted by speckle decorrelation noise, resulting in irregular, nonphysiological tissue displacement fields, smoothing is performed on the displacement data, affecting the strain results. Thus, strain results may depend on the specific implementations of 2-D STE, as well as other systems' characteristics of the various vendors. A novel algorithm (called K-SAD) is introduced, which integrates the physiological constraint of smoothness of the displacement field into an optimization process. Simulated B-mode clips, modeling healthy and abnormal cases, were processed by K-SAD. Peak global and subendocardial longitudinal strains, as well as regional strains, were calculated. In addition, 410 healthy subjects were also processed. The results of K-SAD are compared with those of one of the leading commercial product. K-SAD provides global mid-wall strain values, as well as subendocardial and regional strain values, all in good agreement with the ground-truth-simulated phantom data. K-SAD peak global longitudinal systolic strain values for 410 healthy subjects are quite similar for the different regions: - 17.02 ± 4.02%, - 19.00 ± 3.45%, and - 19.72 ± 5.06% at the basal, mid, and apical regions, respectively. Improved performance under noisy conditions was demonstrated by comparing a subgroup of 40 subjects with the best image quality with the remaining 370 cohort: K-SAD provides statistically similar global and regional results for the two cohorts. Our study indicates that the sensitivity of strain values to speckle noise, caused by the post block-matching weighted smoothing, can be significantly reduced and accuracy enhanced by employing an integrated one-stage, physiologically constrained optimization process.
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Khamis et al. (2016) studied Healthy (n=410). K-SAD algorithm vs. Leading commercial product was evaluated on Peak global, subendocardial, and regional longitudinal strains. The K-SAD speckle tracking algorithm yielded peak global longitudinal systolic strain values of -17.02%, -19.00%, and -19.72% at the basal, mid, and apical regions in 410 healthy subjects.
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