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Repeatability and reproducibility of various 4D Flow MRI postprocessing software programs in a multi-software and

Thekla H Oechtering1,2,3, André Nowak4,5, Malte M Sieren4,5

  • 1Department of Radiology and Nuclear Medicine, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany. Thekla.Oechtering@uksh.de.

Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance
|March 28, 2023
PubMed
Summary

Only two software packages, SW-A and SW-C, demonstrated agreement for key 4D Flow cardiovascular magnetic resonance (CMR) metrics like stroke volume and peak flow. High variability across software and scanners necessitates careful consideration for clinical use.

Keywords:
4D Flow CMRAortaBlood flow velocityFlow quantificationInter-rater comparisonInter-scanner comparisonInter-software comparisonIntra-rater comparisonPhase-contrast magnetic resonance imagingWall shear stress

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Area of Science:

  • Cardiovascular Imaging
  • Medical Software Evaluation
  • Flow Dynamics

Background:

  • Multiple software programs exist for 4D Flow cardiovascular magnetic resonance (CMR) analysis.
  • Ensuring consistency between software is crucial for widespread adoption of 4D Flow CMR.

Purpose of the Study:

  • To compare quantitative results from four different postprocessing software packages.
  • To assess the agreement and equivalence of 4D Flow CMR analysis across different software and scanners.

Main Methods:

  • Eight healthy subjects underwent 3T CMR on two different vendor systems.
  • Standardized 4D Flow CMR sequences were analyzed using four software packages (SW-A, SW-B, SW-C, SW-D).
  • Seven parameters, including stroke volume, peak flow, and wall shear stress, were evaluated with statistical analysis of variability and equivalence testing.

Main Results:

  • SW-A and SW-C showed agreement for stroke volume, peak flow, and area.
  • Peak maximum velocity agreement was poor across most software, except between SW-A and SW-D.
  • Inter-scanner differences were generally smaller than inter-software differences.

Conclusions:

  • Only SW-A and SW-C are equivalent for stroke volume, peak flow, and area determination.
  • High intra- and interreader variability necessitates caution before routine clinical implementation of 4D Flow CMR.
  • Standardizing on a single software package is recommended for multicenter clinical trials.