What question did this study set out to answer?

To evaluate the impact of different software on quantification of left ventricular measurement and parametric mapping using cardiovascular magnetic resonance.

January 1, 2019Open Access

Quantification in cardiovascular magnetic resonance: agreement of software from three different vendors on assessment of left ventricular function, 2D flow and parametric mapping

Key Points

To evaluate the impact of different software on quantification of left ventricular measurement and parametric mapping using cardiovascular magnetic resonance.
Compared three software systems (A, B, C) for left ventricular function and 2D flow analysis on 45 data sets.

Structured PICO

Does the choice of post-processing software impact the quantification of left ventricular function, 2D flow, and parametric mapping in patients undergoing CMR?

Population

31 patients with histologically confirmed soft tissue sarcoma planned for anthracycline-based chemotherapy, mean age 60, 16 male. Exclusion criteria: chronic renal failure (eGFR < 30 mL/m2), cardiac metastases, known incompatibility for gadolinium, contraindication for CMR.

Intervention

Cardiovascular magnetic resonance (CMR) image analysis using three different post-processing software packages (Circle CVI: cvi42, Siemens Healthineers: Argus, Medis: Qmass/Qflow)

Comparator

Comparison of quantitative results among the three software packages

Outcome

Equivalence of software on assessment of left ventricular ejection fraction (EF), end-systolic volume (ESV), end-diastolic volume (EDV), LV mass, forward stroke volume (SV), peak velocity (Vmax), T1-time, and T2-timesurrogate

Different CMR post-processing software packages yield equivalent results for LV volumetry and T2 mapping, but may produce varying results for peak velocity and T1 mapping, highlighting the need to report specific software versions in clinical practice.

Abstract

BACKGROUND: Quantitative results of cardiovascular magnetic resonance (CMR) image analysis influence clinical decision making. Image analysis is performed based on dedicated software. The manufacturers provide different analysis tools whose algorithms are often unknown. The aim of this study was to evaluate the impact of software on quantification of left ventricular (LV) assessment, 2D flow measurement and T1- and T2-parametric mapping. METHODS: , Siemens Healthineers: Argus, Medis: Qmass/Qflow) by one reader blinded to former results. Cine steady state free precession short axis images were analyzed regarding LV ejection fraction (EF), end-systolic and end-diastolic volume (ESV, EDV) and LV mass. Phase-contrast magnetic resonance images were evaluated for forward stroke volume (SV) and peak velocity (Vmax). Pixel-wise generated native T1- and T2-maps were used to assess T1- and T2-time. Forty-five data sets were evaluated twice (15 per software) for intraobserver analysis. Equivalence was considered if the confidence interval of a paired assessment of two sofware was within a tolerance interval defined by ±1.96 highest standard deviation obtained by intraobserver analysis. RESULTS: For each parameter, thirty data sets could be analyzed with all three software. All three software (A/B, A/C, B/C) were considered equivalent for LV EF, EDV, ESV, mass, 2D flow SV and T2-time. Differences between software were detected in flow measurement for Vmax and in parametric mapping for T1-time. For Vmax, equivalence was given between software A and C and for T1-time equivalence was given between software B and C. CONCLUSION: Software had no impact on quantitative results of LV assessment, T2-time and SV based on 2D flow. In contrast to that, Vmax and T1-time may be influenced by software. CMR reports should contain the name and version of the software applied for image analysis to avoid misinterpretation upon follow-up and research examinations. TRIAL REGISTRATION: ISRCTN12210850 . Registered 14 July 2017, retrospectively registered.

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