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Register a new userEarly Detection of Myocardial Infarction in Low-Quality Echocardiography
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Myocardial infarction (MI), or commonly known as heart attack, is a life-threatening health problem worldwide from which 32.4 million people suffer each year. Early diagnosis and treatment of MI are crucial to prevent further heart tissue damages or death. The earliest and most reliable sign of ischemia is regional wall motion abnormality (RWMA) of the affected part of the ventricular muscle. Echocardiography can easily, inexpensively, and non-invasively exhibit the RWMA. In this article, we introduce a three-phase approach for early MI detection in low-quality echocardiography: 1) segmentation of the entire left ventricle (LV) wall using a state-of-the-art deep learning model, 2) analysis of the segmented LV wall by feature engineering, and 3) early MI detection. The main contributions of this study are highly accurate segmentation of the LV wall from low-quality echocardiography, pseudo labeling approach for ground-truth formation of the unannotated LV wall, and the first public echocardiographic dataset (HMC-QU)* for MI detection. Furthermore, the outputs of the proposed approach can significantly help cardiologists for a better assessment of the LV wall characteristics. The proposed approach has achieved 95.72% sensitivity and 99.58% specificity for the LV wall segmentation, and 85.97% sensitivity, 74.03% specificity, and 86.85% precision for MI detection on the HMC-QU dataset. *The benchmark HMC-QU dataset is publicly shared at the repository https://www.kaggle.com/aysendegerli/hmcqu-dataset
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Cardiac imaging known as echocardiography is a non-invasive tool utilized to produce data including images and videos, which cardiologists use to diagnose cardiac abnormalities in general and myocardial infarction (MI) in particular. Echocardiography machines can deliver abundant amounts of data that need to be quickly analyzed by cardiologists to help them make a diagnosis and treat cardiac conditions. However, the acquired data quality varies depending on the acquisition conditions and the patients responsiveness to the setup instructions. These constraints are challenging to doctors especially when patients are facing MI and their lives are at stake. In this paper, we propose an innovative real-time end-to-end fully automated model based on convolutional neural networks (CNN) to detect MI depending on regional wall motion abnormalities (RWMA) of the left ventricle (LV) from videos produced by echocardiography. Our model is implemented as a pipeline consisting of a 2D CNN that performs data preprocessing by segmenting the LV chamber from the apical four-chamber (A4C) view, followed by a 3D CNN that performs a binary classification to detect if the segmented echocardiography shows signs of MI. We trained both CNNs on a dataset composed of 165 echocardiography videos each acquired from a distinct patient. The 2D CNN achieved an accuracy of 97.18% on data segmentation while the 3D CNN achieved 90.9% of accuracy, 100% of precision and 95% of recall on MI detection. Our results demonstrate that creating a fully automated system for MI detection is feasible and propitious.
Automatic myocardial segmentation of contrast echocardiography has shown great potential in the quantification of myocardial perfusion parameters. Segmentation quality control is an important step to ensure the accuracy of segmentation results for quality research as well as its clinical application. Usually, the segmentation quality control happens after the data acquisition. At the data acquisition time, the operator could not know the quality of the segmentation results. On-the-fly segmentation quality control could help the operator to adjust the ultrasound probe or retake data if the quality is unsatisfied, which can greatly reduce the effort of time-consuming manual correction. However, it is infeasible to deploy state-of-the-art DNN-based models because the segmentation module and quality control module must fit in the limited hardware resource on the ultrasound machine while satisfying strict latency constraints. In this paper, we propose a hardware-aware neural architecture search framework for automatic myocardial segmentation and quality control of contrast echocardiography. We explicitly incorporate the hardware latency as a regularization term into the loss function during training. The proposed method searches the best neural network architecture for the segmentation module and quality prediction module with strict latency.
Echocardiogram (echo) is the earliest and the primary tool for identifying regional wall motion abnormalities (RWMA) in order to diagnose myocardial infarction (MI) or commonly known as heart attack. This paper proposes a novel approach, Active Polynomials, which can accurately and robustly estimate the global motion of the Left Ventricular (LV) wall from any echo in a robust and accurate way. The proposed algorithm quantifies the true wall motion occurring in LV wall segments so as to assist cardiologists diagnose early signs of an acute MI. It further enables medical experts to gain an enhanced visualization capability of echo images through color-coded segments along with their maximum motion displacement plots helping them to better assess wall motion and LV Ejection-Fraction (LVEF). The outputs of the method can further help echo-technicians to assess and improve the quality of the echocardiogram recording. A major contribution of this study is the first public echo database collection composed by physicians at the Hamad Medical Corporation Hospital in Qatar. The so-called HMC-QU database will serve as the benchmark for the forthcoming relevant studies. The results over the HMC-QU dataset show that the proposed approach can achieve high accuracy, sensitivity and precision in MI detection even though the echo quality is quite poor, and the temporal resolution is low.
Accurate detection of the myocardial infarction (MI) area is crucial for early diagnosis planning and follow-up management. In this study, we propose an end-to-end deep-learning algorithm framework (OF-RNN ) to accurately detect the MI area at the pixel level. Our OF-RNN consists of three different function layers: the heart localization layers, which can accurately and automatically crop the region-of-interest (ROI) sequences, including the left ventricle, using the whole cardiac magnetic resonance image sequences; the motion statistical layers, which are used to build a time-series architecture to capture two types of motion features (at the pixel-level) by integrating the local motion features generated by long short-term memory-recurrent neural networks and the global motion features generated by deep optical flows from the whole ROI sequence, which can effectively characterize myocardial physiologic function; and the fully connected discriminate layers, which use stacked auto-encoders to further learn these features, and they use a softmax classifier to build the correspondences from the motion features to the tissue identities (infarction or not) for each pixel. Through the seamless connection of each layer, our OF-RNN can obtain the area, position, and shape of the MI for each patient. Our proposed framework yielded an overall classification accuracy of 94.35% at the pixel level, from 114 clinical subjects. These results indicate the potential of our proposed method in aiding standardized MI assessments.
Tissue characterisation with CMR parametric mapping has the potential to detect and quantify both focal and diffuse alterations in myocardial structure not assessable by late gadolinium enhancement. Native T1 mapping in particular has shown promise as a useful biomarker to support diagnostic, therapeutic and prognostic decision-making in ischaemic and non-ischaemic cardiomyopathies. Convolutional neural networks with Bayesian inference are a category of artificial neural networks which model the uncertainty of the network output. This study presents an automated framework for tissue characterisation from native ShMOLLI T1 mapping at 1.5T using a Probabilistic Hierarchical Segmentation (PHiSeg) network. In addition, we use the uncertainty information provided by the PHiSeg network in a novel automated quality control (QC) step to identify uncertain T1 values. The PHiSeg network and QC were validated against manual analysis on a cohort of the UK Biobank containing healthy subjects and chronic cardiomyopathy patients. We used the proposed method to obtain reference T1 ranges for the left ventricular myocardium in healthy subjects as well as common clinical cardiac conditions. T1 values computed from automatic and manual segmentations were highly correlated (r=0.97). Bland-Altman analysis showed good agreement between the automated and manual measurements. The average Dice metric was 0.84 for the left ventricular myocardium. The sensitivity of detection of erroneous outputs was 91%. Finally, T1 values were automatically derived from 14,683 CMR exams from the UK Biobank. The proposed pipeline allows for automatic analysis of myocardial native T1 mapping and includes a QC process to detect potentially erroneous results. T1 reference values were presented for healthy subjects and common clinical cardiac conditions from the largest cohort to date using T1-mapping images.
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