Artificial Intelligence for Automatic Measurement of Left Ventricular Strain in Echocardiography.

artificial intelligence artificial neural networks deep learning echocardiography global longitudinal strain machine learning

Journal

JACC. Cardiovascular imaging
ISSN: 1876-7591
Titre abrégé: JACC Cardiovasc Imaging
Pays: United States
ID NLM: 101467978

Informations de publication

Date de publication:
10 2021
Historique:
received: 20 01 2021
revised: 26 03 2021
accepted: 15 04 2021
pubmed: 21 6 2021
medline: 28 10 2021
entrez: 20 6 2021
Statut: ppublish

Résumé

This study sought to examine if fully automated measurements of global longitudinal strain (GLS) using a novel motion estimation technology based on deep learning and artificial intelligence (AI) are feasible and comparable with a conventional speckle-tracking application. GLS is an important parameter when evaluating left ventricular function. However, analyses of GLS are time consuming and demand expertise, and thus are underused in clinical practice. In this study, 200 patients with a wide range of left ventricle (LV) function were included. Three standard apical cine-loops were analyzed using the AI pipeline. The AI method measured GLS and was compared with a commercially available semiautomatic speckle-tracking software (EchoPAC v202, GE Healthcare. The AI method succeeded to both correctly classify all 3 standard apical views and perform timing of cardiac events in 89% of patients. Furthermore, the method successfully performed automatic segmentation, motion estimates, and measurements of GLS in all examinations, across different cardiac pathologies and throughout the spectrum of LV function. GLS was -12.0 ± 4.1% for the AI method and -13.5 ± 5.3% for the reference method. Bias was -1.4 ± 0.3% (95% limits of agreement: 2.3 to -5.1), which is comparable with intervendor studies. The AI method eliminated measurement variability and a complete GLS analysis was processed within 15 s. Through the range of LV function this novel AI method succeeds, without any operator input, to automatically identify the 3 standard apical views, perform timing of cardiac events, trace the myocardium, perform motion estimation, and measure GLS. Fully automated measurements based on AI could facilitate the clinical implementation of GLS.

Sections du résumé

OBJECTIVES
This study sought to examine if fully automated measurements of global longitudinal strain (GLS) using a novel motion estimation technology based on deep learning and artificial intelligence (AI) are feasible and comparable with a conventional speckle-tracking application.
BACKGROUND
GLS is an important parameter when evaluating left ventricular function. However, analyses of GLS are time consuming and demand expertise, and thus are underused in clinical practice.
METHODS
In this study, 200 patients with a wide range of left ventricle (LV) function were included. Three standard apical cine-loops were analyzed using the AI pipeline. The AI method measured GLS and was compared with a commercially available semiautomatic speckle-tracking software (EchoPAC v202, GE Healthcare.
RESULTS
The AI method succeeded to both correctly classify all 3 standard apical views and perform timing of cardiac events in 89% of patients. Furthermore, the method successfully performed automatic segmentation, motion estimates, and measurements of GLS in all examinations, across different cardiac pathologies and throughout the spectrum of LV function. GLS was -12.0 ± 4.1% for the AI method and -13.5 ± 5.3% for the reference method. Bias was -1.4 ± 0.3% (95% limits of agreement: 2.3 to -5.1), which is comparable with intervendor studies. The AI method eliminated measurement variability and a complete GLS analysis was processed within 15 s.
CONCLUSIONS
Through the range of LV function this novel AI method succeeds, without any operator input, to automatically identify the 3 standard apical views, perform timing of cardiac events, trace the myocardium, perform motion estimation, and measure GLS. Fully automated measurements based on AI could facilitate the clinical implementation of GLS.

Identifiants

pubmed: 34147442
pii: S1936-878X(21)00363-6
doi: 10.1016/j.jcmg.2021.04.018
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1918-1928

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Funding Support and Author Disclosures This work was supported by the Research Council of Norway (Project number 237887), Norwegian Health Association, South-Eastern Norway regional health authority, national program for clinical therapy research (project number 2017207), and Centre for Innovative Ultrasound Solutions, a Norwegian Research Council center for research-based innovation. All authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Auteurs

Ivar M Salte (IM)

Department of Medicine, Hospital of Southern Norway, Kristiansand, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.

Andreas Østvik (A)

Centre for Innovative Ultrasound Solutions and Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.

Erik Smistad (E)

Centre for Innovative Ultrasound Solutions and Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.

Daniela Melichova (D)

Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine, Hospital of Southern Norway, Arendal, Norway.

Thuy Mi Nguyen (TM)

Department of Medicine, Hospital of Southern Norway, Kristiansand, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.

Sigve Karlsen (S)

Department of Medicine, Hospital of Southern Norway, Arendal, Norway.

Harald Brunvand (H)

Department of Medicine, Hospital of Southern Norway, Arendal, Norway.

Kristina H Haugaa (KH)

Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.

Thor Edvardsen (T)

Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.

Lasse Lovstakken (L)

Centre for Innovative Ultrasound Solutions and Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.

Bjørnar Grenne (B)

Centre for Innovative Ultrasound Solutions and Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway; Clinic of Cardiology, St. Olavs Hospital, Trondheim, Norway. Electronic address: bjornar.grenne@ntnu.no.

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