Dataset Information

Reproducibility of cine displacement encoding with stimulated echoes (DENSE) in human subjects.

ABSTRACT: OBJECTIVES:To test the hypothesis that two-dimensional (2D) displacement encoding via stimulated echoes (DENSE) is a reproducible technique for the depiction of segmental myocardial motion in human subjects. MATERIALS AND METHODS:Following the approval of the institutional review board (IRB), 17 healthy volunteers without documented history of cardiovascular disease were recruited. For each participant, 2D DENSE were performed twice (at different days) and the images were obtained at basal, midventricular and apical levels of the left ventricle (LV) with a short-axis view. The radial thickening strain (Err), circumferential strain (Ecc), twist and torsion were calculated. The intra-, inter-observer and inter-study variations of DENSE-derived myocardial motion indices were evaluated using coefficient of variation (CoV) and intra-class correlation coefficient (ICC). RESULTS:In total, there are 272 pairs of myocardial segments (data points) for comparison. There is good intra- and inter-observer reproducibility for all DENSE-derived measures in 17 participants. There is good inter-study reproducibility for peak Ecc (CoV=19.64%, ICC=0.8896, p<0.001), twist (CoV=33.11%, ICC=0.9135, p<0.001) and torsion (CoV=13.96%, ICC=0.8684, p<0.001). There is moderate inter-study reproducibility for Err (CoV=38.89%, ICC=0.7022, p<0.001). CONCLUSION:DENSE is a reproducible technique for characterizing LV regional systolic myocardial motion on a per-segment basis in healthy volunteers.

SUBMITTER: Lin K

PROVIDER: S-EPMC5125889 | biostudies-literature | 2017 Jan

REPOSITORIES: biostudies-literature

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Reproducibility of cine displacement encoding with stimulated echoes (DENSE) in human subjects.

Lin Kai K Meng Leng L Collins Jeremy D JD Chowdhary Varun V Markl Michael M Carr James C JC

Magnetic resonance imaging 20160826

<h4>Objectives</h4>To test the hypothesis that two-dimensional (2D) displacement encoding via stimulated echoes (DENSE) is a reproducible technique for the depiction of segmental myocardial motion in human subjects.<h4>Materials and methods</h4>Following the approval of the institutional review board (IRB), 17 healthy volunteers without documented history of cardiovascular disease were recruited. For each participant, 2D DENSE were performed twice (at different days) and the images were obtained ...[more]

PMID: 27569367

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Project description:PURPOSE:To determine the optimal respiratory navigator gating configuration for the quantification of left ventricular strain using spiral cine displacement encoding with stimulated echoes (DENSE) MRI. MATERIALS AND METHODS:Two-dimensional spiral cine DENSE was performed on a 3 Tesla MRI using two single-navigator configurations (retrospective, prospective) and a combined "dual-navigator" configuration in 10 healthy adults and 20 healthy children. The adults also underwent breathhold DENSE as a reference standard for comparisons. Peak left ventricular strains, signal-to-noise ratio (SNR), and navigator efficiency were compared. Subjects also underwent dual-navigator gating with and without visual feedback to determine the effect on navigator efficiency. RESULTS:There were no differences in circumferential, radial, and longitudinal strains between navigator-gated and breathhold DENSE (P?=?0.09-0.95) (as confidence intervals, retrospective: [-1.0%-1.1%], [-7.4%-2.0%], [-1.0%-1.2%]; prospective: [-0.6%-2.7%], [-2.8%-8.3%], [-0.3%-2.9%]; dual: [-1.6%-0.5%], [-8.3%-3.2%], [-0.8%-1.9%], respectively). The dual configuration maintained SNR compared with breathhold acquisitions (16 versus 18, P?=?0.06). SNR for the prospective configuration was lower than for the dual navigator in adults (P?=?0.004) and children (P?<?0.001). Navigator efficiency was higher (P?<?0.001) for both retrospective (54%) and prospective (56%) configurations compared with the dual configuration (35%). Visual feedback improved the dual configuration navigator efficiency to 55% (P?<?0.001). CONCLUSION:When quantifying left ventricular strains using spiral cine DENSE MRI, a dual navigator configuration results in the highest SNR in adults and children. In adults, a retrospective configuration has good navigator efficiency without a substantial drop in SNR. Prospective gating should be avoided because it has the lowest SNR. Visual feedback represents an effective option to maintain navigator efficiency while using a dual navigator configuration. LEVEL OF EVIDENCE:2 J. Magn. Reson. Imaging 2017;45:786-794.

Project description:Defining myocardial contours is often the most time-consuming portion of dynamic cardiac MRI image analysis. Displacement encoding with stimulated echoes (DENSE) is a quantitative MRI technique that encodes tissue displacement into the phase of the complex MRI images. Cine DENSE provides a time series of these images, thus facilitating the non-invasive study of myocardial kinematics. Epicardial and endocardial contours need to be defined at each frame on cine DENSE images for the quantification of regional displacement and strain as a function of time. This work presents a reliable and effective two-dimensional semi-automated segmentation technique that uses the encoded motion to project a manually-defined region of interest through time. Contours can then easily be extracted for each cardiac phase. This method boasts several advantages, including, (1) parameters are based on practical physiological limits, (2) contours are calculated for the first few cardiac phases, where it is difficult to visually distinguish blood from myocardium, and (3) the method is independent of the shape of the tissue delineated and can be applied to short- or long-axis views, and on arbitrary regions of interest. Motion-guided contours were compared to manual contours for six conventional and six slice-followed mid-ventricular short-axis cine DENSE datasets. Using an area measure of segmentation error, the accuracy of the segmentation algorithm was shown to be similar to inter-observer variability. In addition, a radial segmentation error metric was introduced for short-axis data. The average radial epicardial segmentation error was 0.36+/-0.08 and 0.40+/-0.10 pixels for slice-followed and conventional cine DENSE, respectively, and the average radial endocardial segmentation error was 0.46+/-0.12 and 0.46+/-0.16 pixels for slice following and conventional cine DENSE, respectively. Motion-guided segmentation employs the displacement-encoded phase shifts intrinsic to DENSE MRI to accurately propagate a single set of pre-defined contours throughout the remaining cardiac phases.

Project description:We sought to assess the effectiveness of automated mechanical dyssynchrony (MD) parameters based on regional heterogeneity of strain (circumferential [CURE], longitudinal [LURE], and radial uniformity ratio estimates) relative to parameters based on regional time to peak contraction with cardiac magnetic resonance (CMR) cine DENSE (Displacement Encoding with Stimulated Echoes) validated with myocardial tissue tagging (MTT) strain data.Dyssynchrony measures based on the Fourier transformation (FT) of regional strain, such as CURE (previously evaluated in cardiac resynchronization therapy candidates), directly assess MD and yield straightforward global dyssynchrony indexes; however, performance relative to the 12-segment standard deviation of time to peak strain (SD12) or maximal regional delay in time to peak strain is unknown.Cine DENSE and MTT were obtained with CMR (1.5-T Siemens Avanto, Siemens, Erlangen, Germany) in 13 canines: 3 normal control subjects, 5 with tachycardia pacing-induced heart failure (HF) and left bundle branch ablation (LBBB-HF), and 5 with HF and narrow QRS (NQRS-HF). Strain and dyssynchrony parameters were determined with both CMR methods.Both HF groups had reduced peak strains and left ventricular ejection fraction compared with normal cases. There was strong agreement between cine DENSE and MTT on the basis of intraclass correlation coefficients (CURE: 0.99, 95% CI: 0.96 to 1.00; LURE: 0.92, 95% CI: 0.77 to 0.98; circumferential strain [E(CC)]: 0.95, 95% CI: 0.72 to 0.99; longitudinal strain [E(LL)]: 0.82, 95% CI: 0.42 to 0.97). The FT-based metrics (scale 0 to 1), in particular CURE, discriminated highly between LBBB-HF and NQRS-HF groups (median difference): CURE: 0.60, 95% CI: 0.43 to 0.76; LURE: 0.39, 95% CI: 0.19 to 0.58; radial uniformity ratio estimate: 0.22, 95% CI: 0.04 to 0.40). In contrast, relative confidence intervals for group differences in time-to-peak parameters were wide, indicating less consistent discrimination (median difference): SD12-E(CC): 52.5, 95% CI: -4.0 to 109.2; SD12-E(LL): 40.9, 95% CI: -5.3 to 87.1; SD12-radial strain: 42.0, 95% CI: 0.4 to 83.6). Correlations between FT-based and time-to-peak parameters were significant (CURE/SD12-E(CC): r = -0.62, p = 0.03; LURE/SD12-E(LL): r = -0.76, p = 0.005) but not as tight as correlations between time-to-peak parameters.Automated FT-based circumferential, radial, and longitudinal dyssynchrony measures compare favorably with time-to-peak parameters. Cine DENSE was effective for this application and validated with MTT. Further clinical evaluation in cardiac resynchronization therapy candidates with CMR or other imaging modalities is warranted.

Dataset Information

Reproducibility of cine displacement encoding with stimulated echoes (DENSE) in human subjects.

Publications

Reproducibility of cine displacement encoding with stimulated echoes (DENSE) in human subjects.

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