Deep learning for transesophageal echocardiography view classification.

Journal: Scientific reports
PMID:

Abstract

Transesophageal echocardiography (TEE) imaging is a vital tool used in the evaluation of complex cardiac pathology and the management of cardiac surgery patients. A key limitation to the application of deep learning strategies to intraoperative and intraprocedural TEE data is the complexity and unstructured nature of these images. In the present study, we developed a deep learning-based, multi-category TEE view classification model that can be used to add structure to intraoperative and intraprocedural TEE imaging data. More specifically, we trained a convolutional neural network (CNN) to predict standardized TEE views using labeled intraoperative and intraprocedural TEE videos from Cedars-Sinai Medical Center (CSMC). We externally validated our model on intraoperative TEE videos from Stanford University Medical Center (SUMC). Accuracy of our model was high across all labeled views. The highest performance was achieved for the Trans-Gastric Left Ventricular Short Axis View (area under the receiver operating curve [AUC] = 0.971 at CSMC, 0.957 at SUMC), the Mid-Esophageal Long Axis View (AUC = 0.954 at CSMC, 0.905 at SUMC), the Mid-Esophageal Aortic Valve Short Axis View (AUC = 0.946 at CSMC, 0.898 at SUMC), and the Mid-Esophageal 4-Chamber View (AUC = 0.939 at CSMC, 0.902 at SUMC). Ultimately, we demonstrate that our deep learning model can accurately classify standardized TEE views, which will facilitate further downstream deep learning analyses for intraoperative and intraprocedural TEE imaging.

Authors

  • Kirsten R Steffner
    Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, 300 Pasteur Drive, Stanford, CA, 94305, USA. ksteffner@stanford.edu.
  • Matthew Christensen
    Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, USA.
  • George Gill
    Department of Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, USA.
  • Michael Bowdish
    Department of Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, USA.
  • Justin Rhee
    Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, USA.
  • Abirami Kumaresan
    Department of Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, USA.
  • Bryan He
    Department of Computer Science, Stanford University, Stanford, California.
  • James Zou
    Department of Biomedical Data Science, Stanford University, Stanford, California.
  • David Ouyang
    Division of Artificial Intelligence, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA.