Assessment of Myocardial Deformation in Children Using Digital Imaging and Communications in Medicine (DICOM) Data and Vendor Independent Speckle Tracking Software

Background: Analysis of myocardial deformation from data stored in Digital Imaging and Communications in Medicine format using vendor-independent software may be useful for clinical and research purposes but has not been evaluated in children. Methods: Grayscale images were prospectively acquired on Vivid 7 (GE Healthcare) and iE33 (Philips Medical Systems) ultrasound systems in 49 children. Digital Imaging and Communications in Medicine and raw data were analyzed using vendor-independent software (Cardiac Performance Analysis, Tomtec Imaging Systems) and vendor-specific software (EchoPAC and QLAB) and results compared. In addition, vendor-independent software using images at 30 frames/sec were compared with images at the higher acquisition frame rate. Results: Measurement of short-axis radial and circumferential strain (e) and apical four-chamber longitudinal e by vendor-independent software was possible in > 92% of the children. Intraobserver and interobserver coefficients of variation for global circumferential and longitudinal e ranged from 7.1% to 15.3% and for radial e from 23.9% to 30.2%. Strain values were somewhat higher when using GE images at acquisition frame rates compared with e values using GE images stored at 30 frames/sec. Strain values obtained by vendor-independent software were comparable with those obtained by vendor-specific software for longitudinal e and higher for circumferential e. Radial e values obtained by vendor-independent software were lower than e values by EchoPAC and higher than e values by QLAB. Conclusions: Vendor-independent software-derived e is feasible and potentially valuable for measuring myocardial deformation in research and in multicenter studies using images from different ultrasound systems, especially for longitudinal deformation. However, a systematic bias for circumferential e and a high variability in radial e measurements remain concerns. (J Am Soc Echocardiogr 2011;24:37-44.)