Deep learning assisted measurement of echocardiographic left heart parameters: improvement in interobserver variability and workflow efficiency.

Journal: The international journal of cardiovascular imaging
PMID:

Abstract

Machine learning techniques designed to recognize views and perform measurements are increasingly used to address the need for automation of the interpretation of echocardiographic images. The current study was designed to determine whether a recently developed and validated deep learning (DL) algorithm for automated measurements of echocardiographic parameters of left heart chamber size and function can improve the reproducibility and shorten the analysis time, compared to the conventional methodology. The DL algorithm trained to identify standard views and provide automated measurements of 20 standard parameters, was applied to images obtained in 12 randomly selected echocardiographic studies. The resultant measurements were reviewed and revised as necessary by 10 independent expert readers. The same readers also performed conventional manual measurements, which were averaged and used as the reference standard for the DL-assisted approach with and without the manual revisions. Inter-reader variability was quantified using coefficients of variation, which together with analysis times, were compared between the conventional reads and the DL-assisted approach. The fully automated DL measurements showed good agreement with the reference technique: Bland-Altman biases 0-14% of the measured values. Manual revisions resulted in only minor improvement in accuracy: biases 0-11%. This DL-assisted approach resulted in a 43% decrease in analysis time and less inter-reader variability than the conventional methodology: 2-3 times smaller coefficients of variation. In conclusion, DL-assisted approach to analysis of echocardiographic images can provide accurate left heart measurements with the added benefits of improved reproducibility and time savings, compared to conventional methodology.

Authors

  • Victor Mor-Avi
    Cardiac Imaging Center, University of Chicago Medical Center, Chicago, Illinois.
  • Alexandra Blitz
    TOMTEC Imaging Systems, Unterschleissheim, Germany.
  • Marcus Schreckenberg
    TOMTEC Imaging Systems GmbH, Freisinger Str. 9, 85716 Unterschleissheim, Germany.
  • Karima Addetia
    Department of Medicine, University of Chicago Medical Center, 5758 South Maryland Ave, MC 9067 Room 5513, Chicago, IL, USA.
  • Kalie Kebed
    University of Chicago Medical Center, Chicago, Illinois.
  • Gregory Scalia
    Genesis Care, Brisbane, Australia.
  • Luigi P Badano
    Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
  • James N Kirkpatrick
    University of Washington, Seattle, WA, USA.
  • Pedro Gutierrez-Fajardo
    Hospital de Especialidades San Francisco de Asis, Guadalajara, Jalisco, Mexico.
  • Ana Clara Tude Rodrigues
    Albert Einstein Hospital, Sao Paulo, Brazil.
  • Anita Sadeghpour
    MedStar Heart and Vascular Institute/Health Research Institute, Washington, DC, USA.
  • Edwin S Tucay
    Philippine Heart Center, Quezon City, Philippines.
  • Aldo D Prado
    Centro Privado de Cardiologia, Tucumán, Argentina.
  • Wendy Tsang
    Toronto General Hospital, University of Toronto, Toronto, ON, Canada.
  • Kofo O Ogunyankin
    First Cardiology Consultants Hospital, Lagos, Nigeria.
  • Alexander Rossmanith
    TOMTEC Imaging Systems, Unterschleissheim, Germany.
  • Georg Schummers
    TomTec Imaging Systems GmbH, Unterschleissheim, Germany.
  • Dorottya Laczik
    TOMTEC Imaging Systems, Unterschleissheim, Germany.
  • Federico M Asch
    MedStar Health Research Institute, Washington DC (F.M.A.).
  • Roberto M Lang
    Cardiac Imaging Center, University of Chicago Medical Center, Chicago, Illinois.