Mitral regurgitation quantification by cardiac magnetic resonance imaging (MRI) remains reproducible between software solutions

Background: The reproducibility of mitral regurgitation (MR) quantification by cardiovascular magnetic resonance (CMR) imaging using different software solutions remains unclear. This research aimed to investigate the reproducibility of MR quantification between two software solutions: MASS (version 2019 EXP, LUMC, Netherlands) and CAAS (version 5.2, Pie Medical Imaging). Methods: CMR data of 35 patients with MR (12 primary MR, 13 mitral valve repair/replacement, and ten secondary MR) was used. Four methods of MR volume quantification were studied, including two 4D-flow CMR methods (MR (MVAV) and MR (Jet)) and two non-4D-flow techniques (MR (Standard) and MR (LVRV)). We conducted within-software and inter-software correlation and agreement analyses. Results: All methods demonstrated significant correlation between the two software solutions: MR (Standard )(r=0.92, p<0.001), MR (LVRV )(r=0.95, p<0.001), MR (Jet )(r=0.86, p<0.001), and MR (MVAV )(r=0.91, p<0.001). Between CAAS and MASS, MR (Jet) and MR (MVAV), compared to each of the four methods, were the only methods not to be associated with significant bias. Conclusions: We conclude that 4D-flow CMR methods demonstrate equivalent reproducibility to non-4D-flow methods but greater levels of agreement between software solutions.