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Funding Acknowledgements Type of funding sources: Other. Main funding source(s): Medical Research Scotland(MRS) Guerbet Group Background Cardiac MR texture analysis (TA) has the potential to distinguish subtle differences amongst myocardial diseases, but with limited evidence in a healthy population. The aim of this study was to assess the application of TA to cardiac CINE MR Images of the left ventricle to evaluate variability and consistency in a large-scale healthy population.  Method A cohort of 600 healthy volunteers was recruited from the Tayside Screening for Prevention of Cardiac Events study. All subjects underwent short axis CINE CMR at 3T (including LVM), using a 2D ECG-gated breath-hold segmented steady-state gradient echo sequence with constant field-of-view and pixel size.  For each subject, the mid short-axis slices of the left ventricle, at ED and ES, were extracted for image analysis. The TA parameters (n = 50) for all images were derived using Mazda v4.7 by a single observer. Three different regions-of-interest (ROI) were applied to the LV myocardium at ED and ES, as follows:  1) ‘whole wall’ (figure 1 a and d); 2) ‘septal wall’ (figure 1 b and e); and 3) ‘lateral wall’ (figure 1 c and f).  Statistical comparisons were made for all texture features to establish how they varied between ED and ES, males versus females, different age ranges (40-45 years, 46-54 years, 55-63 years, and ≥ 64 years) and also between those with small (66.8 ± 5.88 g/m2), media (98.2 ± 15.28 g/m2) and large (146.2 ± 16.81 g/m2) LVM.  Finally, the images of 30 volunteers were analysed by a second observer to derive test-retest inter-observer variation as an index of measurement repeatability for each TA feature. Results   Of the original 50 TA features tested, the means of n = 45-49 features (number dependent on whether whole wall, septal wall or lateral wall) were significantly different when compared between ED and ES (p &amp;lt; 0.05). For comparisons with gender, the means of n = 36-43 of the original features were significantly different (p &amp;lt; 0.05).  Additionally, the means of n = 15-29 features were significantly different when tested between sub-cohorts of different ages (p &amp;lt; 0.05). When these data were combined together, ‘lateral wall’ was less sensitive, but for ‘whole wall’ and ‘septal wall’, the means of n = 7 of the original TA features were able to identify statistically significant differences between (i) ED and ES, (ii) males and females, (iii) different sub-cohorts of age, and (iv) different sub-cohorts of LVM (figure 2).  Further, the root mean square test-retest inter-observer coefficient of variation associated with the repeatability of these measures was &amp;lt;10%. The n = 7 most useful TA features were ‘GrMean’, ‘GrNonZeros’, ‘Average_RLNonUni’, ‘Average_LngREmph’, ‘Average_ShrtREmph’, ‘Average_Fraction’ and ‘S5_Average_Entropy’. Conclusion   These findings showed the repeatability of CMR texture anaysis and capability to identify differences in a healthy population. Further work may identify whether these features are able to differentiate between different cardiovascular diseases.

The use of cardiac MRI texture analysis to investigate left ventricle tissue characterisation in a healthy UK population