Machine Learning for Pediatric Echocardiographic Mitral Regurgitation Detection.


Journal

Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
ISSN: 1097-6795
Titre abrégé: J Am Soc Echocardiogr
Pays: United States
ID NLM: 8801388

Informations de publication

Date de publication:
01 2023
Historique:
received: 06 03 2021
revised: 23 09 2022
accepted: 24 09 2022
pubmed: 4 10 2022
medline: 10 1 2023
entrez: 3 10 2022
Statut: ppublish

Résumé

Echocardiography-based screening for valvular disease in at-risk asymptomatic children can result in early diagnosis. These screening programs, however, are resource intensive and may not be feasible in many resource-limited settings. Automated echocardiographic diagnosis may enable more widespread echocardiographic screening, early diagnosis, and improved outcomes. In this feasibility study, the authors sought to build a machine learning model capable of identifying mitral regurgitation (MR) on echocardiography. Echocardiograms were labeled by clip for view and by frame for the presence of MR. The labeled data were used to build two convolutional neural networks to perform the stepwise tasks of classifying the clips (1) by view and (2) by the presence of any MR, including physiologic, in parasternal long-axis color Doppler views. The view classification model was developed using 66,330 frames, and model performance was evaluated using a hold-out testing data set with 45 echocardiograms (11,730 frames). The MR detection model was developed using 938 frames, and model performance was evaluated using a hold-out testing data set with 42 echocardiograms (182 frames). Metrics to evaluate model performance included accuracy, precision, recall, F1 score (average of precision and recall, ranging from 0 to 1, with 1 suggesting perfect precision and recall), and receiver operating characteristic analysis. For the parasternal long-axis view with color Doppler, the view classification convolutional neural network achieved an F1 score of 0.97. The MR detection convolutional neural network achieved testing accuracy of 0.86 and an area under the receiver operating characteristic curve of 0.91. A machine learning model is capable of discerning MR on transthoracic echocardiography. This is an encouraging step toward machine learning-based diagnosis of valvular heart disease on pediatric echocardiography.

Sections du résumé

BACKGROUND
Echocardiography-based screening for valvular disease in at-risk asymptomatic children can result in early diagnosis. These screening programs, however, are resource intensive and may not be feasible in many resource-limited settings. Automated echocardiographic diagnosis may enable more widespread echocardiographic screening, early diagnosis, and improved outcomes. In this feasibility study, the authors sought to build a machine learning model capable of identifying mitral regurgitation (MR) on echocardiography.
METHODS
Echocardiograms were labeled by clip for view and by frame for the presence of MR. The labeled data were used to build two convolutional neural networks to perform the stepwise tasks of classifying the clips (1) by view and (2) by the presence of any MR, including physiologic, in parasternal long-axis color Doppler views. The view classification model was developed using 66,330 frames, and model performance was evaluated using a hold-out testing data set with 45 echocardiograms (11,730 frames). The MR detection model was developed using 938 frames, and model performance was evaluated using a hold-out testing data set with 42 echocardiograms (182 frames). Metrics to evaluate model performance included accuracy, precision, recall, F1 score (average of precision and recall, ranging from 0 to 1, with 1 suggesting perfect precision and recall), and receiver operating characteristic analysis.
RESULTS
For the parasternal long-axis view with color Doppler, the view classification convolutional neural network achieved an F1 score of 0.97. The MR detection convolutional neural network achieved testing accuracy of 0.86 and an area under the receiver operating characteristic curve of 0.91.
CONCLUSIONS
A machine learning model is capable of discerning MR on transthoracic echocardiography. This is an encouraging step toward machine learning-based diagnosis of valvular heart disease on pediatric echocardiography.

Identifiants

pubmed: 36191670
pii: S0894-7317(22)00482-5
doi: 10.1016/j.echo.2022.09.017
pii:
doi:

Types de publication

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

Langues

eng

Sous-ensembles de citation

IM

Pagination

96-104.e4

Informations de copyright

Copyright © 2022 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

Auteurs

Lindsay A Edwards (LA)

Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington.

Fei Feng (F)

University of Michigan-Shanghai Jiao Tong University Joint Institute, Shanghai Jiao Tong University, Shanghai, China.

Mehreen Iqbal (M)

Department of Pediatrics, Stanford University School of Medicine, Stanford, California.

Yong Fu (Y)

University of Michigan-Shanghai Jiao Tong University Joint Institute, Shanghai Jiao Tong University, Shanghai, China.

Amy Sanyahumbi (A)

Department of Pediatrics, Baylor College of Medicine, Houston, Texas.

Shiying Hao (S)

Department of Cardiothoracic Surgery, Stanford University School of Medicine, Palo Alto, California.

Doff B McElhinney (DB)

Department of Cardiothoracic Surgery, Stanford University School of Medicine, Palo Alto, California.

X Bruce Ling (XB)

Department of Surgery, Stanford University School of Medicine, Stanford, California.

Craig Sable (C)

Department of Pediatrics, Children's National Health System, Washington, District of Columbia.

Jiajia Luo (J)

Biomedical Engineering Department, Peking University, Beijing, China. Electronic address: jiajia.luo@pku.edu.cn.

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