4942Automated recognition of regional wall motion abnormalities by deep neural network interpretation of echocardiography

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M S Huang ◽  
M R Tsai

Abstract Background The deep neural network assisted in automated echocardiography interpretation joint to cardiologist final confirmation has now been gradually emerging. There were applications applied in echocardiography views classification, chamber size and myocardium mass evaluation, and certain disease detections already published. Our aim, instead of frame-by-frame “image-level” interpretation in previous studies, is to apply deep neural network in echocardiography temporal relationship analysis – “video-level” – and applied in automated left ventricle myocardium regional wall motion abnormalities recognition. Methods We collected all echocardiography performed in 2017, and preprocessed them into numeric arrays for matrix computations. Regional wall motion abnormalities were approved by authorized cardiologists, and processed into labels whether regional wall motion abnormalities presented in anterior, inferior, septal, or lateral walls of the left ventricle, as the ground truth. We then first developed a convolutional neural network (CNN) model to do view selection, and gathered parasternal long/short views, and apical four/two chamber views from each exam, as well as developing view prediction confidence for strict image quality control. Within these images, we annotated part of images to develop the second CNN model, known as U-net, for image segmentation and mark each regional wall. Finally, we developed the major three-dimensional CNN model with the inputs composed of four views of echocardiography videos and then output the final label for motion abnormalities in each wall. Results In total we collected 13,984 series of echocardiography, and gathered four main views with quality confidence level above 90%, which resulted in 9,323 series for training. Within these images, we annotated 2,736 frames for U-net model and resulted in dice score of segmentation 73%. With the join of segmentation model, the final three-dimensional CNN model predict regional wall motion with accuracy of 83%. Conclusions Deep neural network application in regional wall motion recognition is feasible and should mandate further investigation for promoting performance. Acknowledgement/Funding None

Circulation ◽  
2020 ◽  
Vol 142 (16) ◽  
pp. 1510-1520 ◽  
Author(s):  
Mu-Shiang Huang ◽  
Chi-Shiang Wang ◽  
Jung-Hsien Chiang ◽  
Ping-Yen Liu ◽  
Wei-Chuan Tsai

Background: Automated interpretation of echocardiography by deep neural networks could support clinical reporting and improve efficiency. Whereas previous studies have evaluated spatial relationships using still frame images, we aimed to train and test a deep neural network for video analysis by combining spatial and temporal information, to automate the recognition of left ventricular regional wall motion abnormalities. Methods: We collected a series of transthoracic echocardiography examinations performed between July 2017 and April 2018 in 2 tertiary care hospitals. Regional wall abnormalities were defined by experienced physiologists and confirmed by trained cardiologists. First, we developed a 3-dimensional convolutional neural network model for view selection ensuring stringent image quality control. Second, a U-net model segmented images to annotate the location of each left ventricular wall. Third, a final 3-dimensional convolutional neural network model evaluated echocardiographic videos from 4 standard views, before and after segmentation, and calculated a wall motion abnormality confidence level (0–1) for each segment. To evaluate model stability, we performed 5-fold cross-validation and external validation. Results: In a series of 10 638 echocardiograms, our view selection model identified 6454 (61%) examinations with sufficient image quality in all standard views. In this training set, 2740 frames were annotated to develop the segmentation model, which achieved a Dice similarity coefficient of 0.756. External validation was performed in 1756 examinations from an independent hospital. A regional wall motion abnormality was observed in 8.9% and 4.9% in the training and external validation datasets, respectively. The final model recognized regional wall motion abnormalities in the cross-validation and external validation datasets with an area under the receiver operating characteristic curve of 0.912 (95% CI, 0.896–0.928) and 0.891 (95% CI, 0.834–0.948), respectively. In the external validation dataset, the sensitivity was 81.8% (95% CI, 73.8%–88.2%), and specificity was 81.6% (95% CI, 80.4%–82.8%). Conclusions: In echocardiographic examinations of sufficient image quality, it is feasible for deep neural networks to automate the recognition of regional wall motion abnormalities using temporal and spatial information from moving images. Further investigation is required to optimize model performance and evaluate clinical applications.


1986 ◽  
Vol 58 (6) ◽  
pp. 406-410 ◽  
Author(s):  
Nagara Tamaki ◽  
Tsunehiro Yasuda ◽  
Robert C. Leinbach ◽  
Herman K. Gold ◽  
Kenneth A. McKusick ◽  
...  

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