Key result
The non-rigid, elastic image registration algorithm (Segment) showed significantly higher agreement and correlation (r = 0.84) with the reference standard CMR tagging for global peak systolic circumferential strain compared to the blood myocardial border tracing algorithm (TomTec, r = 0.36).
Why the study?
Several software packages employ different algorithms to compute feature-tracking strain, but the impact of the underlying algorithm on the validity and robustness of results required investigation.
Does the type of feature-tracking algorithm impact the validity and robustness of FT-derived strain results compared to CMR tagging in patients with aortic stenosis and healthy controls?
Cross-Sectional (n=30)
No
Does the type of feature-tracking algorithm impact the validity and robustness of FT-derived strain results compared to CMR tagging in patients with aortic stenosis and healthy controls?
p-value: p=0.0125
The non-rigid, elastic image registration algorithm produces more precise and reproducible strain results than the blood myocardium tracing algorithm when compared to CMR tagging.
Segment may be preferable for CMR strain analysis; extends validation of elastic registration but leaves open clinical impact.
Introduction Optical flow feature-tracking (FT) strain assessment is increasingly being employed scientifically and clinically. Several software packages, employing different algorithms, enable computation of FT-derived strains. The aim of this study is to investigate the impact of the underlying algorithm on the validity and robustness of FT-derived strain results. Material and methods CSPAMM and SSFP cine sequences were acquired in 30 subjects (15 patients with aortic stenosis and associated secondary hypertrophic cardiomyopathy, and 15 controls) in identical midventricular short-axis locations. Global peak systolic circumferential strain (PSCS) was calculated using tagging and feature-tracking software with different algorithms (non-rigid, elastic image registration, and blood myocardial border tracing). Intermodality agreement and intra- as well inter-observer variability were assessed. Results Intermodality/inter-algorithm comparison for global PSCS using Friedman’s test revealed statistically significant differences (tagging vs. blood myocardial border tracing algorithm). Intermodality assessment revealed the highest correlation between tagging and non-rigid, elastic image registration (r = 0.84), while correlation between tagging and blood myocardial border tracing (r = 0.36) and between the two feature-tracking software packages (r = 0.5) were considerably lower. Conclusions The type of algorithm employed during feature-tracking strain assessment has a significant impact on the results. The non-rigid, elastic image registration algorithm produces more precise and reproducible results than the blood myocardium tracing algorithm.
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Thomas et al. (2020) conducted a cross-sectional in Aortic stenosis and associated hypertrophic cardiomyopathy (n=30). Feature-tracking algorithms (non-rigid elastic image registration vs. blood myocardial border tracing) vs. CMR tagging (reference standard) was evaluated on Global peak systolic circumferential strain (PSCS) intermodality differences (p=0.0125). The non-rigid, elastic image registration algorithm (Segment) showed significantly higher agreement and correlation (r = 0.84) with the reference standard CMR tagging for global peak systolic circumferential strain compared to the blood myocardial border tracing algorithm (TomTec, r = 0.36).
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