Automated Estimation of Left Myocardial Strain from Cine CTA: A Comparison with Cine MRI

Cardiovascular disease, the leading cause of death in the U.S., affects both the heart and blood vessels. Contrast-enhanced cardiac computed tomography angiography (CTA) is a prominent imaging modality for assessing heart and coronary artery morphology, aiding in the diagnosis of cardiovascular disease. Cine CTA, which captures multiple 3D heart images throughout the cardiac cycle, is particularly useful for evaluating nonischemic cardiomyopathy, a common cause of heart failure unrelated to coronary artery disease. Key biomarkers, such as left ventricular ejection fraction, which measures the amount of blood pumped from the heart’s lower chambers per contraction, and myocardial strain, which evaluates the deformation of the heart muscle during contraction and relaxation, are vital for assessing heart function. We developed an automated artificial intelligence (AI) framework to segment various cardiac structures across all image volumes representing different phases of the cardiac cycle. The framework also automatically extracts three short-axis slices to calculate the myocardial strain in the left ventricle. The results are compared with strain measurements obtained from cardiovascular magnetic resonance (CMR) cine imaging. Our study shows both radial and circumferential strains from cine CTA are comparable to those from cine CMR. The proposed AI framework facilitates a comprehensive evaluation of myocardial function throughout the cine CTA, supporting improved diagnostic accuracy.