Applying masked autoencoder-based self-supervised learning for high-capability vision transformers of electrocardiographies.

Journal: PloS one
Published Date:

Abstract

The generalization of deep neural network algorithms to a broader population is an important challenge in the medical field. We aimed to apply self-supervised learning using masked autoencoders (MAEs) to improve the performance of the 12-lead electrocardiography (ECG) analysis model using limited ECG data. We pretrained Vision Transformer (ViT) models by reconstructing the masked ECG data with MAE. We fine-tuned this MAE-based ECG pretrained model on ECG-echocardiography data from The University of Tokyo Hospital (UTokyo) for the detection of left ventricular systolic dysfunction (LVSD), and then evaluated it using multi-center external validation data from seven institutions, employing the area under the receiver operating characteristic curve (AUROC) for assessment. We included 38,245 ECG-echocardiography pairs from UTokyo and 229,439 pairs from all institutions. The performances of MAE-based ECG models pretrained using ECG data from UTokyo were significantly higher than that of other Deep Neural Network models across all external validation cohorts (AUROC, 0.913-0.962 for LVSD, p < 0.001). Moreover, we also found improvements for the MAE-based ECG analysis model depending on the model capacity and the amount of training data. Additionally, the MAE-based ECG analysis model maintained high performance even on the ECG benchmark dataset (PTB-XL). Our proposed method developed high performance MAE-based ECG analysis models using limited ECG data.

Authors

  • Shinnosuke Sawano
    Department of Cardiovascular Medicine, The University of Tokyo.
  • Satoshi Kodera
    Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo.
  • Naoto Setoguchi
    Division of Cardiology, Mitsui Memorial Hospital.
  • Kengo Tanabe
    Division of Cardiology, Mitsui Memorial Hospital.
  • Shunichi Kushida
    Department of Cardiovascular Medicine, Asahi General Hospital.
  • Junji Kanda
    Department of Cardiovascular Medicine, Asahi General Hospital.
  • Mike Saji
    Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan.
  • Mamoru Nanasato
    Department of Cardiology, Sakakibara Heart Institute.
  • Hisataka Maki
    Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University.
  • Hideo Fujita
    Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University.
  • Nahoko Kato
    Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center.
  • Hiroyuki Watanabe
    Graduate School of Health Sciences, Showa University, Tookaichibacho, Midori-ku, Yokohama, Kanagawa, Japan.
  • Minami Suzuki
    Department of Cardiology, JR General Hospital.
  • Masao Takahashi
    Department of Radiology, Saitama Medical University, 38 Morohongou, Moroyama-machi, Iruma-gun, Saitama, Japan.
  • Naoko Sawada
    Department of Cardiovascular Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
  • Masao Yamasaki
    Department of Cardiology, NTT Medical Center Tokyo.
  • Masataka Sato
    Department of Cardiovascular Medicine, The University of Tokyo Hospital.
  • Susumu Katsushika
    Department of Cardiovascular Medicine, The University of Tokyo.
  • Hiroki Shinohara
    Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo.
  • Norifumi Takeda
    Department of Cardiovascular Medicine, The University of Tokyo.
  • Katsuhito Fujiu
    Department of Cardiovascular Medicine, The University of Tokyo.
  • Masao Daimon
    Department of Cardiovascular Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
  • Hiroshi Akazawa
    Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo.
  • Hiroyuki Morita
    Department of Cardiovascular Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
  • Issei Komuro
    Department of Cardiovascular Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.