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3. Inter-vendor variability in strain measurements depends on software rather than image characteristics

Author

Unlu S., Mirea O., Bezy S., Duchenne J., Pagourelias E. D., Bogaert J., Thomas J. D., Badano L., Voigt J. -U., Hamilton J., Pedri S., Lysyansky P., Hansen G., Ito Y., Chono T., Vogel J., Prater D., Song J. H., Lee J. Y., Houle H., Georgescu B., Baumann R., Mumm B., Abe Y., Gorissen W., Unlu, S, Mirea, O, Bezy, S, Duchenne, J, Pagourelias, E, Bogaert, J, Thomas, J, Badano, L, Voigt, J, Hamilton, J, Pedri, S, Lysyansky, P, Hansen, G, Ito, Y, Chono, T, Vogel, J, Prater, D, Song, J, Lee, J, Houle, H, Georgescu, B, Baumann, R, Mumm, B, Abe, Y, and Gorissen, W

Subjects
Longitudinal strain, Vendor, Delayed enhancement, 030204 cardiovascular system & hematology, Strain, 030218 nuclear medicine & medical imaging, Image (mathematics), 03 medical and health sciences, 0302 clinical medicine, Software, Range (statistics), Medicine, Radiology, Nuclear Medicine and imaging, Variability, health care economics and organizations, Reproducibility, business.industry, Significant difference, Pattern recognition, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Independent, Artificial intelligence, Cardiology and Cardiovascular Medicine, business
Abstract

Despite standardization efforts, vendors still use specific proprietary software algorithms for echocardiographic strain measurements, which result in high inter-vendor variability. Using vendor-independent software could be one solution. Little is known, however, how vendor specific image characteristics can influence tracking results of such software. We therefore investigated the reproducibility, accuracy, and scar detection ability of strain measurements on images from different vendors by using a vendor-independent software. A vendor-independent software (TomTec Image Arena) was used to analyse datasets of 63 patients which were obtained on machines from four different ultrasound machine vendors (GE, Philips, Siemens, Toshiba). We measured the tracking feasibility, inter-vendor bias, the relative test-re-test variability and scar discrimination ability of strain measurements. Cardiac magnetic resonance delayed enhancement images were used as the reference standard of scar definition. Tracking feasibility on vendor datasets were significantly different (p < 0.001). Variability of global longitudinal strain (GLS) measurements was similar among the vendors whereas variability of segmental longitudinal strain (SLS) showed modest difference. Relative test-re-test variability of GLS and SLS showed no relevant differences. No significant difference in scar detection capability was observed. Average GLS and SLS values were similar among vendors. Reproducibility of GLS measurements showed no difference among vendors and was in acceptable range. SLS reproducibility was high but similar for all vendors. No relevant difference was found for identifying regional dysfunction. Tracking feasibility showed a substantial difference among images from different vendors. Our findings demonstrate that tracking results depend mainly on the software used and show little influence from vendor specific image characteristics.

Published
2021
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7. Inter-vendor variability in strain measurements depends on software rather than image characteristics

Author

Unlu, S, Mirea, O, Bezy, S, Duchenne, J, Pagourelias, E, Bogaert, J, Thomas, J, Badano, L, Voigt, J, Hamilton, J, Pedri, S, Lysyansky, P, Hansen, G, Ito, Y, Chono, T, Vogel, J, Prater, D, Song, J, Lee, J, Houle, H, Georgescu, B, Baumann, R, Mumm, B, Abe, Y, Gorissen, W, Unlu S., Mirea O., Bezy S., Duchenne J., Pagourelias E. D., Bogaert J., Thomas J. D., Badano L., Voigt J. -U., Hamilton J., Pedri S., Lysyansky P., Hansen G., Ito Y., Chono T., Vogel J., Prater D., Song J. H., Lee J. Y., Houle H., Georgescu B., Baumann R., Mumm B., Abe Y., Gorissen W., Unlu, S, Mirea, O, Bezy, S, Duchenne, J, Pagourelias, E, Bogaert, J, Thomas, J, Badano, L, Voigt, J, Hamilton, J, Pedri, S, Lysyansky, P, Hansen, G, Ito, Y, Chono, T, Vogel, J, Prater, D, Song, J, Lee, J, Houle, H, Georgescu, B, Baumann, R, Mumm, B, Abe, Y, Gorissen, W, Unlu S., Mirea O., Bezy S., Duchenne J., Pagourelias E. D., Bogaert J., Thomas J. D., Badano L., Voigt J. -U., Hamilton J., Pedri S., Lysyansky P., Hansen G., Ito Y., Chono T., Vogel J., Prater D., Song J. H., Lee J. Y., Houle H., Georgescu B., Baumann R., Mumm B., Abe Y., and Gorissen W.

Abstract

Despite standardization efforts, vendors still use specific proprietary software algorithms for echocardiographic strain measurements, which result in high inter-vendor variability. Using vendor-independent software could be one solution. Little is known, however, how vendor specific image characteristics can influence tracking results of such software. We therefore investigated the reproducibility, accuracy, and scar detection ability of strain measurements on images from different vendors by using a vendor-independent software. A vendor-independent software (TomTec Image Arena) was used to analyse datasets of 63 patients which were obtained on machines from four different ultrasound machine vendors (GE, Philips, Siemens, Toshiba). We measured the tracking feasibility, inter-vendor bias, the relative test-re-test variability and scar discrimination ability of strain measurements. Cardiac magnetic resonance delayed enhancement images were used as the reference standard of scar definition. Tracking feasibility on vendor datasets were significantly different (p < 0.001). Variability of global longitudinal strain (GLS) measurements was similar among the vendors whereas variability of segmental longitudinal strain (SLS) showed modest difference. Relative test-re-test variability of GLS and SLS showed no relevant differences. No significant difference in scar detection capability was observed. Average GLS and SLS values were similar among vendors. Reproducibility of GLS measurements showed no difference among vendors and was in acceptable range. SLS reproducibility was high but similar for all vendors. No relevant difference was found for identifying regional dysfunction. Tracking feasibility showed a substantial difference among images from different vendors. Our findings demonstrate that tracking results depend mainly on the software used and show little influence from vendor specific image characteristics.

Published
2021

16. Layer-Specific Segmental Longitudinal Strain Measurements: Capability of Detecting Myocardial Scar and Differences in Feasibility, Accuracy, and Reproducibility, Among Four Vendors A Report From the EACVI-ASE Strain Standardization Task Force

Author

Unlu, S, Mirea, O, Pagourelias, E, Duchenne, J, Bezy, S, Bogaert, J, Thomas, J, Badano, L, Voigt, J, Unlu S., Mirea O., Pagourelias E. D., Duchenne J., Bezy S., Bogaert J., Thomas J. D., Badano L, Voigt J. -U., Unlu, S, Mirea, O, Pagourelias, E, Duchenne, J, Bezy, S, Bogaert, J, Thomas, J, Badano, L, Voigt, J, Unlu S., Mirea O., Pagourelias E. D., Duchenne J., Bezy S., Bogaert J., Thomas J. D., Badano L, and Voigt J. -U.

Abstract

Background: Segmental longitudinal strain (SLS)is reported to be vendor specific. Despite standardization efforts, vendors still use different myocardial layers for strain measurements. It is unclear, however, which layer is the most favorable for clinical purposes. Therefore, in this study we evaluated the reproducibility, accuracy, and scar detection ability of SLS measurements from different myocardial layers. Methods: In data sets of 58 patients with prior myocardial infarction and five healthy volunteers, we measured the intervendor bias, the relative test-retest variability, and scar discrimination ability of endocardial and midwall SLS, using software packages from four different companies (GE, Siemens, Toshiba, and TomTec). Cardiac magnetic resonance delayed enhancement images were used as the reference standard of scar definition. Results: Variability of SLS measurements was significant among the vendors for both midwall and endocardium. In addition, relative errors of SLS measurements varied considerably among vendors (P <.001 for both layers). Comparisons of test-retest errors from different layers for individual vendors did not show any significant differences. Regardless of the vendor, both endocardial and midwall strain values were decreased in scarred segments. Endocardial to midwall ratio of strain measurements showed no difference between scar-free and scarred segments. Endocardial and midwall strain parameters showed no significant difference in scar detection capability. Conclusions: Layer-specific SLS measurements vary significantly among vendors. Endocardial and midwall SLS measurements have a high yet comparable test-retest variability. Combining layer-specific SLS measurements does not provide additional information for detection of regional functional abnormalities. Our results do not provide evidence to favor the use of one myocardial layer over another.

Published
2019

21. Comparison of Feasibility, Accuracy, and Reproducibility of Layer-Specific Global Longitudinal Strain Measurements Among Five Different Vendors: A Report from the EACVI-ASE Strain Standardization Task Force

Author

Unlu, S, Mirea, O, Duchenne, J, Pagourelias, E, Bezy, S, Thomas, J, Badano, L, Voigt, J, Unlu S., Mirea O., Duchenne J., Pagourelias E. D., Bezy S., Thomas J. D., Badano L., Voigt J. -U., Unlu, S, Mirea, O, Duchenne, J, Pagourelias, E, Bezy, S, Thomas, J, Badano, L, Voigt, J, Unlu S., Mirea O., Duchenne J., Pagourelias E. D., Bezy S., Thomas J. D., Badano L., and Voigt J. -U.

Abstract

Background: Despite standardization efforts, vendors still use information from different myocardial layers to calculate global longitudinal strain ( GLS). Little is known about potential advantages or disadvantages of using these different layers in clinical practice. The authors therefore investigated the reproducibility and accuracy of GLS measurements from different myocardial layers.Methods: Sixty-three subjects were prospectively enrolled, in whom the intervendor bias and test-retest variability of endocardial GLS ( E-GLS) and midwall GLS ( M-GLS) were calculated, using software packages from five vendors that allow layer-specific GLS calculation ( GE, Hitachi, Siemens, Toshiba, and TomTec). The impact of tracking quality and the interdependence of strain values from different layers were assessed by comparing test-retest errors between layers.Results: For both E-GLS and M-GLS, significant bias was found among vendors. Relative test-retest variability of E-GLS values differed significantly among vendors, whereas M-GLS showed no significant difference ( range, 5.4%-9.5% [ P =.032] and 7.0%-11.2% [ P =.200], respectively). Within-vendor test-retest variability was similar between E-GLS and M-GLS for all but one vendor. Absolute test-retest errors were highly correlated between E-GLS and M-GLS for all vendors.Conclusions: E-GLS and M-GLS measurements showed no relevant differences in robustness among vendors, although intervendor bias was higher for M-GLS compared with E-GLS. These data provide no technical argument in favor of a certain myocardial layer for global left ventricular functional assessment. Currently, the choice of which layer to use should therefore be based on the available clinical evidence in the literature. ( J Am Soc Echocardiogr 2018; 31: 374-80.)

Published
2018

22. Can shear wave imaging distinguish between diffuse interstitial and replacement myocardial fibrosis?

Author

Petrescu, ANIELA, primary, Cvijic, M, additional, Bezy, S, additional, Santos, P, additional, Duchenne, J, additional, Orlowska, M, additional, Pedrosa, J, additional, Degtiarova, G, additional, Van Keer, J, additional, Von Bardeleben, S, additional, Droogne, W, additional, Van Cleemput, J, additional, Bogaert, J, additional, D"hooge, J, additional, and Voigt, J-U, additional

Published
2021
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30. Shear wave elastography by high frame rate echocardiography can detect diffuse myocardial fibrosis after heart transplantation

Author

Petrescu, A, primary, Bezy, S, additional, Cvijic, M, additional, Santos, P, additional, Duchenne, J, additional, Orlowska, M, additional, Van Keer, J, additional, Von Bardeleben, S, additional, Droogne, W, additional, Bogaert, J, additional, Van Cleemput, J, additional, D'hooge, J, additional, and Voigt, J.-U, additional

Published
2020
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32. Differentiation of hypertensive heart disease and hypertrophic cardiomyopathy with myocardial stiffness measurements: a shear wave imaging study using ultra-high frame rate echocardiography

Author

Cvijic, M, primary, Bezy, S, additional, Petrescu, A, additional, Santos, P, additional, Orlowska, M, additional, Chakraborty, B, additional, Duchenne, J, additional, Pedrosa, J, additional, Vanassche, T, additional, Van Cleemput, J, additional, Dhooge, J, additional, and Voigt, J.U, additional

Published
2020
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34. 556 Shear wave imaging using ultra-high frame rate echocardiography for the assessment of structural changes in cardiac transplant recipients

Author

Petrescu, A M, primary, Bezy, S, additional, Cvijic, M, additional, Santos, P, additional, Orlowska, M, additional, Pedrosa, J, additional, Van Keer, J, additional, Duchenne, J, additional, Bogaert, J, additional, Van Cleemput, J, additional, Von Bardeleben, S, additional, D"hooge, J, additional, and Voigt, J U, additional

Published
2020
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36. 417 Can myocardial stiffness measurements distinguish the underlying pathology in hearts with thick walls? A shear wave imaging study using ultra-high frame rate echocardiography

Author

Cvijic, M, primary, Bezy, S, additional, Petrescu, A, additional, Santos, P, additional, Orlowska, M, additional, Chakraborty, B, additional, Duchenne, J, additional, Pedrosa, J, additional, Vanassche, T, additional, Delforge, M, additional, Van Cleemput, J, additional, Dhooge, J, additional, and Voigt, J U, additional

Published
2020
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37. 553 Acute re-distribution of regional left ventricular work by cardiac resynchronization therapy determines long-term remodelling

Author

Duchenne, J, primary, Aalen, J M, additional, Cvijic, M, additional, Larsen, C K, additional, Galli, E, additional, Bezy, S, additional, Beela, A S, additional, Winter, S, additional, Penicka, M, additional, Hopp, E, additional, Kongsgard, E, additional, Donal, E, additional, Fehske, W, additional, Smiseth, O A, additional, and Voigt, J U, additional

Published
2020
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38. P1238Acute re-distribution of myocardial work by cardiac resynchronization therapy determines long-term remodelling of the left ventricle

Author

Duchenne, J, primary, Aalen, J, additional, Cvijic, M, additional, Larsen, K, additional, Galli, E, additional, Bezy, S, additional, Beela, A S, additional, Unlu, S, additional, Pagourelias, E D, additional, Winter, S, additional, Hopp, E, additional, Fehske, W, additional, Donal, E, additional, Smiseth, O A, additional, and Voigt, J U, additional

Published
2019
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44. HIT moderated posters session: imaging of tomorrowP88Contribution of LV dilatation and left bundle branch block to functional mitral regurgitation in DCM heartsP89Can we predict improvement of secondary mitral regurgitation after CRT?P90Dual-energy computed tomography myocardial perfusion to detect coronary artery disease and predict need of revascularizationP91Prognostic role of ventricular-arterial coupling after cardiac surgeryP93Long-term prognostic determinants in valvular aortic stenosis - is optimized medical therapy an option?P94Diagnostic performance and prognostic value of cardiopulmonary ultrasound for the early diagnosis of postoperative heart failure after cardiac surgeryP95Does tricuspid annuloplasty increases surgical mortality and morbidity during mitral valve replacement?

Author

Duchenne, J., primary, Michalski, BW., primary, Valente, F., primary, Bianco, F., primary, Almeida Morais, L., primary, Ricci, F., primary, Darmon, A., primary, Bezy, S., additional, Claus, P., additional, Pagourelias, E., additional, Gheysens, O., additional, Rega, F., additional, Voigt, J-U, additional, Stankovic, I., additional, Paqourelias, E., additional, Faber, L., additional, Ciarka, A., additional, Aarones, M., additional, Winter, S., additional, Aakhus, S., additional, Fehske, W., additional, Voigt, JU., additional, Ruiz-Munoz, A., additional, Galian, L., additional, Dux-Santoy, L., additional, Pizzi, N., additional, Aguade, S., additional, Otaegui, I., additional, Huguet, M., additional, Sao-Avilez, A., additional, Gutierrez, L., additional, Maldonado, G., additional, Gonzalez-Alujas, T., additional, Garcia-Dorado, D., additional, Evangelista, A., additional, Rodriguez-Palomares, JF., additional, Bucciarelli, V., additional, Ricci, F., additional, Aquilani, R., additional, Di Pace, GG., additional, Miniera, E., additional, De Caterina, R., additional, Gallina, S., additional, Santos, N., additional, Moura Branco, L., additional, Galrinho, A., additional, Aguiar Rosa, S., additional, Rodrigues, I., additional, Portugal, G., additional, Pinto-Teixeira, P., additional, Viveiros-Monteiro, A., additional, Cruz-Ferreira, R., additional, Dipace, G., additional, Bianco, F., additional, Miniero, E., additional, Verdonk, C., additional, Lepage, L., additional, Cimadevilla, C., additional, Nataf, P., additional, Vahanian, A., additional, and Messika-Zeitoun, D., additional

Published
2016
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45. Layer-Specific Segmental Longitudinal Strain Measurements: Capability of Detecting Myocardial Scar and Differences in Feasibility, Accuracy, and Reproducibility, Among Four Vendors A Report From the EACVI-ASE Strain Standardization Task Force

Author

Jürgen Duchenne, EACVI-ASE-Industry Standardization Task Force, Oana Mirea, Jan Bogaert, Serkan Ünlü, Jens-Uwe Voigt, S Bezy, Efstathios D. Pagourelias, James D. Thomas, Luigi P. Badano, Unlu, S, Mirea, O, Pagourelias, E, Duchenne, J, Bezy, S, Bogaert, J, Thomas, J, Badano, L, and Voigt, J

Subjects
Standardization, Longitudinal strain, Myocardial Infarction, Delayed enhancement, 030204 cardiovascular system & hematology, Layer-specific, Strain, 030218 nuclear medicine & medical imaging, Cicatrix, 03 medical and health sciences, 0302 clinical medicine, Speckle, Nuclear Medicine and Imaging, Image Interpretation, Computer-Assisted, Healthy volunteers, Humans, Medicine, Radiology, Nuclear Medicine and imaging, health care economics and organizations, Intervendor, Reproducibility, Tracking, Radiology, Nuclear Medicine and Imaging, Cardiology and Cardiovascular Medicine, Endocardium, integumentary system, business.industry, Task force, Reproducibility of Results, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Magnetic Resonance Imaging, Echocardiography, Feasibility Studies, Radiology, business, Cardiac magnetic resonance, Software, Biomedical engineering
Abstract

Background: Segmental longitudinal strain (SLS)is reported to be vendor specific. Despite standardization efforts, vendors still use different myocardial layers for strain measurements. It is unclear, however, which layer is the most favorable for clinical purposes. Therefore, in this study we evaluated the reproducibility, accuracy, and scar detection ability of SLS measurements from different myocardial layers. Methods: In data sets of 58 patients with prior myocardial infarction and five healthy volunteers, we measured the intervendor bias, the relative test-retest variability, and scar discrimination ability of endocardial and midwall SLS, using software packages from four different companies (GE, Siemens, Toshiba, and TomTec). Cardiac magnetic resonance delayed enhancement images were used as the reference standard of scar definition. Results: Variability of SLS measurements was significant among the vendors for both midwall and endocardium. In addition, relative errors of SLS measurements varied considerably among vendors (P

Published
2019
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46. Comparison of Feasibility, Accuracy, and Reproducibility of Layer-Specific Global Longitudinal Strain Measurements Among Five Different Vendors: A Report from the EACVI-ASE Strain Standardization Task Force

Author

S Bezy, Serkan Ünlü, Jens-Uwe Voigt, Luigi P. Badano, Efstathios D. Pagourelias, Jürgen Duchenne, Oana Mirea, James D. Thomas, Unlu, S, Mirea, O, Duchenne, J, Pagourelias, E, Bezy, S, Thomas, J, Badano, L, and Voigt, J

Subjects
Male, Standardization, Longitudinal strain, Heart Ventricles, Siemens, 030204 cardiovascular system & hematology, Layer-specific, Ventricular Function, Left, Strain, 03 medical and health sciences, 0302 clinical medicine, Speckle, Nuclear Medicine and Imaging, Image Interpretation, Computer-Assisted, Statistics, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Prospective Studies, 030212 general & internal medicine, Intervendor, Reproducibility, Tracking, Radiology, Nuclear Medicine and Imaging, Cardiology and Cardiovascular Medicine, health care economics and organizations, Task force, business.industry, Significant difference, Reproducibility of Results, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Myocardial Contraction, Healthy Volunteers, Clinical Practice, ROC Curve, Echocardiography, Clinical evidence, Feasibility Studies, Female, Radiology, business
Abstract

Background: Despite standardization efforts, vendors still use information from different myocardial layers to calculate global longitudinal strain ( GLS). Little is known about potential advantages or disadvantages of using these different layers in clinical practice. The authors therefore investigated the reproducibility and accuracy of GLS measurements from different myocardial layers.Methods: Sixty-three subjects were prospectively enrolled, in whom the intervendor bias and test-retest variability of endocardial GLS ( E-GLS) and midwall GLS ( M-GLS) were calculated, using software packages from five vendors that allow layer-specific GLS calculation ( GE, Hitachi, Siemens, Toshiba, and TomTec). The impact of tracking quality and the interdependence of strain values from different layers were assessed by comparing test-retest errors between layers.Results: For both E-GLS and M-GLS, significant bias was found among vendors. Relative test-retest variability of E-GLS values differed significantly among vendors, whereas M-GLS showed no significant difference ( range, 5.4%-9.5% [ P =.032] and 7.0%-11.2% [ P =.200], respectively). Within-vendor test-retest variability was similar between E-GLS and M-GLS for all but one vendor. Absolute test-retest errors were highly correlated between E-GLS and M-GLS for all vendors.Conclusions: E-GLS and M-GLS measurements showed no relevant differences in robustness among vendors, although intervendor bias was higher for M-GLS compared with E-GLS. These data provide no technical argument in favor of a certain myocardial layer for global left ventricular functional assessment. Currently, the choice of which layer to use should therefore be based on the available clinical evidence in the literature. ( J Am Soc Echocardiogr 2018; 31: 374-80.)

Published
2018
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47. Evaluation of left ventricular filling pressure by echocardiography in patients with atrial fibrillation.

Author

Khan FH, Zhao D, Ha JW, Nagueh SF, Voigt JU, Klein AL, Gude E, Broch K, Chan N, Quill GM, Doughty RN, Young A, Seo JW, García-Izquierdo E, Moñivas-Palomero V, Mingo-Santos S, Wang TKM, Bezy S, Ohte N, Skulstad H, Beladan CC, Popescu BA, Kikuchi S, Panis V, Donal E, Remme EW, Nash MP, and Smiseth OA

Abstract

Background: Echocardiography is widely used to evaluate left ventricular (LV) diastolic function in patients suspected of heart failure. For patients in sinus rhythm, a combination of several echocardiographic parameters can differentiate between normal and elevated LV filling pressure with good accuracy. However, there is no established echocardiographic approach for the evaluation of LV filling pressure in patients with atrial fibrillation. The objective of the present study was to determine if a combination of several echocardiographic and clinical parameters may be used to evaluate LV filling pressure in patients with atrial fibrillation., Results: In a multicentre study of 148 atrial fibrillation patients, several echocardiographic parameters were tested against invasively measured LV filling pressure as the reference method. No single parameter had sufficiently strong association with LV filling pressure to be recommended for clinical use. Based on univariate regression analysis in the present study, and evidence from existing literature, we developed a two-step algorithm for differentiation between normal and elevated LV filling pressure, defining values ≥ 15 mmHg as elevated. The parameters in the first step included the ratio between mitral early flow velocity and septal mitral annular velocity (septal E/e'), mitral E velocity, deceleration time of E, and peak tricuspid regurgitation velocity. Patients who could not be classified in the first step were tested in a second step by applying supplementary parameters, which included left atrial reservoir strain, pulmonary venous systolic/diastolic velocity ratio, and body mass index. This two-step algorithm classified patients as having either normal or elevated LV filling pressure with 75% accuracy and with 85% feasibility. Accuracy in EF ≥ 50% and EF < 50% was similar (75% and 76%)., Conclusions: In patients with atrial fibrillation, no single echocardiographic parameter was sufficiently reliable to be used clinically to identify elevated LV filling pressure. An algorithm that combined several echocardiographic parameters and body mass index, however, was able to classify patients as having normal or elevated LV filling pressure with moderate accuracy and high feasibility., (© 2024. The Author(s).)

Published
2024
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48. Transmural Wave Speed Gradient May Distinguish Intrinsic Myocardial Stiffening From Preload-Induced Changes in Operational Stiffness in Shear Wave Elastography.

Author

Caenen A, Bezy S, Petrescu A, Werner A, Voigt JU, D'hooge J, and Segers P

Subjects
Humans, Heart diagnostic imaging, Myocardium, Microsurgery, Elasticity Imaging Techniques methods
Abstract

Background: Shear wave elastography (SWE) is a promising technique to non-invasively assess myocardial stiffness based on the propagation speed of mechanical waves. However, a high wave propagation speed can either be attributed to an elevated intrinsic myocardial stiffness or to a preload-induced increase in operational stiffness., Objective: Our objective was to find a way to discriminate intrinsic myocardial stiffening from stiffening caused by an increased pressure in SWE., Methods: We used the finite element method to study the shear wave propagation patterns when stiffness and/or pressure is elevated, compared to normal stiffness and pressure. Numerical findings were verified in a few human subjects., Results: The transmural wave speed gradient was able to distinguish changes in intrinsic stiffness from those induced by differing hemodynamic load (a speed of ±3.2 m/s in parasternal short-axis (PSAX) view was associated with a wave speed gradient of -0.17 ± 0.15 m/s/mm when pressure was elevated compared to 0.04 ± 0.05 m/s/mm when stiffness was elevated). The gradient however decreased when stiffness increased (decrease with a factor 3 in PSAX when stiffness doubled at 20 mmHg). The human data analysis confirmed the presence of a wave speed gradient in a patient with elevated ventricular pressure., Conclusion: Cardiac SWE modeling is a useful tool to gain additional insights into the complex wave physics and to guide post-processing. The transmural differences in wave speed may help to distinguish loading-induced stiffening from intrinsic stiffness changes., Significance: The transmural wave speed gradient has potential as a new diagnostic parameter for future clinical studies.

Published
2023
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49. In Vivo Comparison of Multiline Transmission and Diverging Wave Imaging for High-Frame-Rate Speckle-Tracking Echocardiography.

Author

Orlowska M, Ramalli A, Bezy S, Meacci V, Voigt JU, and D'Hooge J

Subjects
Algorithms, Humans, Reproducibility of Results, Echocardiography, Echocardiography, Stress
Abstract

High-frame-rate (HFR) speckle-tracking echocardiography (STE) assesses myocardial function by quantifying motion and deformation at high temporal resolution. Among the proposed HFR techniques, multiline transmission (MLT) and diverging wave (DW) imaging have been used in this context both being characterized by specific advantages and disadvantages. Therefore, in this article, we directly contrast both approaches in an in vivo setting while operating at the same frame rate (FR). First, images were recorded at baseline (resting condition) from healthy volunteers and patients. Next, additional acquisitions during stress echocardiography were performed on volunteers. Each scan was contoured and processed by a previously proposed 2-D HFR STE algorithm based on cross correlation. Then, strain curves and their end-systolic (ES) values were extracted for all myocardial segments for further statistical analysis. The baseline acquisitions did not reveal differences in estimated strain between the acquisition modes ( ); myocardial segments ( ); or an interaction between imaging mode and depth ( ). Similarly, during stress testing, no difference ( p = 0.7 ) was observed for the two scan sequences, stress levels or an interaction sequence-stress level ( p = 0.94 ). Overall, our findings show that MLT and DW compoundings give comparable HFR STE strain values and that the choice for using one method or the other may thus rather be based on other factors, for example, system requirements or computational cost.

Published
2021
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50. A Novel 2-D Speckle Tracking Method for High-Frame-Rate Echocardiography.

Author

Orlowska M, Ramalli A, Petrescu A, Cvijic M, Bezy S, Santos P, Pedrosa J, Voigt JU, and D'hooge J

Subjects
Adult, Algorithms, Female, Heart diagnostic imaging, Humans, Male, Echocardiography methods, Image Processing, Computer-Assisted methods
Abstract

Speckle tracking echocardiography (STE) is a clinical tool to noninvasively assess regional myocardial function through the quantification of regional motion and deformation. Even if the time resolution of STE can be improved by high-frame-rate (HFR) imaging, dedicated HFR STE algorithms have to be developed to detect very small interframe motions. Therefore, in this article, we propose a novel 2-D STE method, purposely developed for HFR echocardiography. The 2-D motion estimator consists of a two-step algorithm based on the 1-D cross correlations to separately estimate the axial and lateral displacements. The method was first optimized and validated on simulated data giving an accuracy of ~3.3% and ~10.5% for the axial and lateral estimates, respectively. Then, it was preliminarily tested in vivo on ten healthy volunteers showing its clinical applicability and feasibility. Moreover, the extracted clinical markers were in the same range as those reported in the literature. Also, the estimated peak global longitudinal strain was compared with that measured with a clinical scanner showing good correlation and negligible differences (-20.94% versus -20.31%, p -value = 0.44). In conclusion, a novel algorithm for STE was developed: the radio frequency (RF) signals were preferred for the axial motion estimation, while envelope data were preferred for the lateral motion. Furthermore, using 2-D kernels, even for 1-D cross correlation, makes the method less sensitive to noise.

Published
2020
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