EchoAtlas: A Conversational, Multi-View Vision-Language Foundation Model for Echocardiography Interpretation and Clinical Reasoning

Journal: medRxiv
Published Date:

Abstract

Echocardiography is the most widely used cardiac imaging modality, yet artificial intelligence-enabled interpretation remains limited by the inability of existing models to integrate visual assessment, quantitative measurement, and clinical reasoning within a unified framework. Here we present EchoAtlas, the first autoregressive vision-language model developed for echocardiographic interpretation. Trained on over 12.9 million question-answer pairs derived from approximately 2 million echocardiogram videos, EchoAtlas achieves 0.966 accuracy on multiple-choice questions in our internal test set and establishes a new state-of-the-art on the public MIMIC-EchoQA benchmark (0.699 vs. 0.508 previously). EchoAtlas also provides accurate quantitative measurements, segment-level regional wall motion assessment, longitudinal comparison, and diagnostic reasoning across diverse question formats-capabilities not previously demonstrated in this domain. These results highlight the potential of autoregressive vision-language models as a foundation for interactive echocardiographic interpretation, representing an early step toward scalable, auditable artificial intelligence systems in cardiology practice.

Authors

  • Chao
  • C.-J.; Asadi
  • M.; Li
  • L.; Ramasamy
  • G.; Pecco
  • N.; Wang
  • Y.-C.; Poterucha
  • T.; Arsanjani
  • R.; Kane
  • G. C.; Oh
  • J. K.; Banerjee
  • I.; Langlotz
  • C. P.; Fei-Fei
  • L.; Adeli
  • E.; Erickson
  • B. J.