title: Regional cardiac motion and strain estimation in three-dimensional echocardiography: a validation study in thick-walled univentricular phantoms.
abstract: Automatic quantification of regional left ventricular deformation in volumetric ultrasound data remains challenging. Many methods have been proposed to extract myocardial motion, including techniques using block matching, phase-based correlation, differential optical flow methods, and image registration. Our lab previously presented an approach based on elastic registration of subsequent volumes using a B-spline representation of the underlying transformation field. Encouraging results were obtained for the assessment of global left ventricular function, but a thorough validation on a regional level was still lacking. For this purpose, univentricular thick-walled cardiac phantoms were deformed in an experimental setup to locally assess strain accuracy against sonomicrometry as a reference method and to assess whether regions containing stiff inclusions could be detected. Our method showed good correlations against sonomicrometry: r(2) was 0.96, 0.92, and 0.84 for the radial (ε(RR)), longitudinal (ε(LL)), and circumferential (ε(CC)) strain, respectively. Absolute strain errors and strain drift were low for ε(LL) (absolute mean error: 2.42%, drift: -1.05%) and ε(CC) (error: 1.79%, drift: -1.33%) and slightly higher for ε(RR) (error: 3.37%, drift: 3.05%). The discriminative power of our methodology was adequate to resolve full transmural inclusions down to 17 mm in diameter, although the inclusion-to-surrounding tissue stiffness ratio was required to be at least 5:2 (absolute difference of 39.42 kPa). When the inclusion-to-surrounding tissue stiffness ratio was lowered to approximately 2:1 (absolute difference of 22.63 kPa), only larger inclusions down to 27 mm in diameter could still be identified. Radial strain was found not to be reliable in identifying dysfunctional regions.
authors.affiliation: Laboratory of Cardiovascular Imaging and Dynamics, University of Leuven (KU Leuven), Leuven, Belgium. brecht.heyde@med.kuleuven.be
authors.forename: Brecht
authors.initials: B
authors.lastname: Heyde
authors.forename: Szymon
authors.initials: S
authors.lastname: Cygan
authors.forename: Hon Fai
authors.initials: HF
authors.lastname: Choi
authors.forename: Beata
authors.initials: B
authors.lastname: Lesniak-Plewinska
authors.forename: Daniel
authors.initials: D
authors.lastname: Barbosa
authors.forename: An
authors.initials: A
authors.lastname: Elen
authors.forename: Piet
authors.initials: P
authors.lastname: Claus
authors.forename: Dirk
authors.initials: D
authors.lastname: Loeckx
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Kaluzynski
authors.forename: Jan
authors.initials: J
authors.lastname: D'hooge
mesh_terms: D019560:Echocardiography, Three-Dimensional / Q000295:instrumentation* / Q000379:methods*; D006321:Heart / Q000502:physiology*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008954:Models, Biological; D019047:Phantoms, Imaging; D015203:Reproducibility of Results