Cardiovascular Magnetic Resonance Imaging Feature Tracking: Impact of Training on Observer Performance and Reproducibility

Authors

Sören J. Backhaus, Georg-August Universitat Gottingen
Georg Metschies, Georg-August Universitat Gottingen
Marcus Billing, Georg-August Universitat Gottingen
Johannes T. Kowallick, Georg-August Universitat Gottingen
Roman J. Gertz, Georg-August Universitat Gottingen
Tomas Lapinskas, University of Berlin
Burkert Pieske, University of Berlin
Joachim Lotz, Georg-August Universitat Gottingen
Boris Bigalke, University Medical Center Berlin
Shelby Kutty, University of Nebraska Medical CenterFollow
Gerd Hasenfuß, Georg-August Universitat Gottingen
Philipp Beerbaum, Hanover Medical School
Sebastian Kelle, University of Berlin
Andreas Schuster, Georg-August Universitat Gottingen

Document Type

Article

Journal Title

PLoS One

Publication Date

2019

Volume

14

Abstract

BACKGROUND: Cardiovascular magnetic resonance feature tracking (CMR-FT) is increasingly used for myocardial deformation assessment including ventricular strain, showing prognostic value beyond established risk markers if used in experienced centres. Little is known about the impact of appropriate training on CMR-FT performance. Consequently, this study aimed to evaluate the impact of training on observer variance using different commercially available CMR-FT software.

METHODS: Intra- and inter-observer reproducibility was assessed prior to and after dedicated one-hour observer training. Employed FT software included 3 different commercially available platforms (TomTec, Medis, Circle). Left (LV) and right (RV) ventricular global longitudinal as well as LV circumferential and radial strains (GLS, GCS and GRS) were studied in 12 heart failure patients and 12 healthy volunteers.

RESULTS: Training improved intra- and inter-observer reproducibility. GCS and LV GLS showed the highest reproducibility before (ICC >0.86 and >0.81) and after training (ICC >0.91 and >0.92). RV GLS and GRS were more susceptible to tracking inaccuracies and reproducibility was lower. Inter-observer reproducibility was lower than intra-observer reproducibility prior to training with more pronounced improvements after training. Before training, LV strain reproducibility was lower in healthy volunteers as compared to patients with no differences after training. Whilst LV strain reproducibility was sufficient within individual software solutions inter-software comparisons revealed considerable software related variance.

CONCLUSION: Observer experience is an important source of variance in CMR-FT derived strain assessment. Dedicated observer training significantly improves reproducibility with most profound benefits in states of high myocardial contractility and potential to facilitate widespread clinical implementation due to optimized robustness and diagnostic performance.

DOI Link

10.1371/journal.pone.0210127

ISSN

1932-6203

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Recommended Citation

Backhaus, Sören J.; Metschies, Georg; Billing, Marcus; Kowallick, Johannes T.; Gertz, Roman J.; Lapinskas, Tomas; Pieske, Burkert; Lotz, Joachim; Bigalke, Boris; Kutty, Shelby; Hasenfuß, Gerd; Beerbaum, Philipp; Kelle, Sebastian; and Schuster, Andreas, "Cardiovascular Magnetic Resonance Imaging Feature Tracking: Impact of Training on Observer Performance and Reproducibility" (2019). Journal Articles: Pediatrics. 17.
https://digitalcommons.unmc.edu/com_peds_articles/17