Inter-vendor reproducibility and accuracy of segmental left ventricular strain measurements using CMR feature tracking

  • Monica DobrovieEmail author
  • Manuel Barreiro-Pérez
  • Davide Curione
  • Rolf Symons
  • Piet Claus
  • Jens-Uwe Voigt
  • Jan Bogaert



Our aim was to evaluate the inter-vendor reproducibility of cardiovascular MR feature tracking (CMR-FT) for the measurement of segmental strain (SS) of the left ventricle (LV) as well as to test the accuracy of CMR-FT to detect regional myocardial pathology.


We selected 45 patients: 15 with normal CMR findings, 15 with dilated cardiomyopathy, and 15 with acute myocardial infarction. Segmental longitudinal, circumferential, and radial strains were assessed with 4 different software. The inter-vendor difference as well as intra- and inter-observer variability was investigated. Furthermore, the accuracy of CMR-FT for the detection of structural (infarcted segments) as well as functional pathology (septal vs. lateral wall strain in left bundle branch block) was tested.


Between vendors, there were significant differences in values for all strains (p < 0.001). The software using a non-rigid algorithm for image registration and segmentation demonstrated the best intra- as well as inter-observer variability with interclass correlation coefficient (ICC) > 0.962 and coefficient of variation (CV) < 24%. For infarct location, the same software yielded the highest area under the curve values for radial and circumferential SS (0.872 and 0.859, respectively). One of the other three software using optical flow technology performed best for longitudinal SS (0.799) and showed the largest differences in SS between septum and lateral wall in the dilated cardiomyopathy group.


SS values obtained by CMR-FT are not interchangeable between vendors, and intra- and inter-observer reproducibility shows substantial variability among vendors. Overall, the different packages score relatively well to depict focal structural or functional LV pathology.

Key Points

Segmental myocardial strain values obtained by CMR feature tracking are not interchangeable between different vendors.

Intra- and inter-observer reproducibility shows substantial variability among vendors.

Segmental myocardial strains measured by CMR feature tracking score relatively well to depict focal structural or functional LV pathology.


Magnetic resonance imaging Myocardium Myocardial infarction Dilated cardiomyopathy 



Cardiovascular magnetic resonance feature tracking


Coefficient of variation


Interclass correlation coefficient


Left ventricle


Segmental circumferential strain


Segmental longitudinal strain


Segmental radial strain



The authors state that this work has not received any funding.

Compliance with ethical standards


The scientific guarantor of this publication is Professor Jan Bogaert.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

Several authors have significant statistical expertise.

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was not required for this study because of its retrospective nature.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

The study subjects and cohorts have been previously reported in the paper published by our group: Barreiro-Pérez M, Curione D, Symons R, Claus P, Voigt JU, Bogaert J. Left ventricular global myocardial strain assessment comparing the reproducibility of four commercially available CMR-feature tracking algorithms. Eur Radiol. 2018 Jun 5. [Epub ahead of print] doi:


• retrospective

• cross-sectional study

• performed at one institution

Supplementary material

330_2019_6315_MOESM1_ESM.docx (22 kb)
ESM 1 (DOCX 21 kb)


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Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  1. 1.Department of Imaging and Pathology, University Hospitals LeuvenKU Leuven – University of LeuvenLeuvenBelgium
  2. 2.Cardiovascular Disease Emergency Institute CC Iliescu BucharestBucharestRomania
  3. 3.Servicio de Cardiología, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, y CIBERCVUniversidad de SalamancaSalamancaSpain
  4. 4.Advanced Cardiovascular Imaging Unit – Radiology and Bioimaging DepartmentBambino Gesù Children’s Hospital IRCCSRomeItaly
  5. 5.Laboratory on Cardiovascular Imaging & Dynamics, Department of Cardiovascular SciencesKU Leuven – University of LeuvenLeuvenBelgium
  6. 6.Department of Cardiovascular SciencesKU Leuven – University of LeuvenLeuvenBelgium

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