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Int J Cardiovasc Imaging. 2024;40(6):1245-1256.

Artificial intelligence-enhanced automation for M-mode echocardiographic analysis: ensuring fully automated, reliable, and reproducible measurements.

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제1저자 정다운, 정성희 · 교신저자 윤연이

소속 (10)
  1. Department of Internal Medicine, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, South Korea.
  2. CONNECT-AI Research Center, Yonsei University College of Medicine, Seoul, South Korea.
  3. Ontact Health Inc, Seoul, South Korea.
  4. Ontact Health Inc, Seoul, South Korea. yeonyeeyoon@gmail.com.
  5. Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Gumi-Ro 173, Bundang-Gu, Seongnam, Gyeonggi-Do, 13620, South Korea. yeonyeeyoon@gmail.com.
  6. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea. yeonyeeyoon@gmail.com.
  7. Graduate School of Biomedical Engineering, Yonsei University College of Medicine, Seoul, South Korea.
  8. Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Gumi-Ro 173, Bundang-Gu, Seongnam, Gyeonggi-Do, 13620, South Korea.
  9. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
  10. Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea.

Abstract

To enhance M-mode echocardiography's utility for measuring cardiac structures, we developed and evaluated an artificial intelligence (AI)-based automated analysis system for M-mode images through the aorta and left atrium [M-mode (Ao-LA)], and through the left ventricle [M-mode (LV)]. Our system, integrating two deep neural networks (DNN) for view classification and image segmentation, alongside an auto-measurement algorithm, was developed using 5,958 M-mode images [3,258 M-mode (LA-Ao), and 2,700 M-mode (LV)] drawn from a nationwide echocardiographic dataset collated from five tertiary hospitals. The performance of view classification and segmentation DNNs were evaluated on 594 M-mode images, while automatic measurement accuracy was tested on separate internal test set with 100 M-mode images as well as external test set with 280 images (140 sinus rhythm and 140 atrial fibrillation). Performance evaluation showed the view classification DNN's overall accuracy of 99.8% and segmentation DNN's Dice similarity coefficient of 94.3%. Within the internal test set, all automated measurements, including LA, Ao, and LV wall and cavity, resonated strongly with expert evaluations, exhibiting Pearson's correlation coefficients (PCCs) of 0.81-0.99. This performance persisted in the external test set for both sinus rhythm (PCC, 0.84-0.98) and atrial fibrillation (PCC, 0.70-0.97). Notably, automatic measurements, consistently offering multi-cardiac cycle readings, showcased a stronger correlation with the averaged multi-cycle manual measurements than with those of a single representative cycle. Our AI-based system for automatic M-mode echocardiographic analysis demonstrated excellent accuracy, reproducibility, and speed. This automated approach has the potential to improve efficiency and reduce variability in clinical practice.

© 2024. The Author(s), under exclusive licence to Springer Nature B.V.

Keywords

Artificial IntelligenceAutomatic quantificationDeep learningEchocardiographyM-mode

그 밖의 정보
출판 형태
Journal Article, Multicenter Study, Evaluation Study
저널
The international journal of cardiovascular imaging · eISSN 1875-8312
전자 출판
2024-04-23
MeSH
Humans · Reproducibility of Results · Predictive Value of Tests* · Echocardiography* · Automation* · Image Interpretation, Computer-Assisted* · Databases, Factual · Deep Learning · Heart Ventricles / diagnostic imaging / physiopathology · Heart Atria / diagnostic imaging / physiopathology · Atrial Fibrillation / diagnostic imaging / physiopathology · Female · Male · Observer Variation · Middle Aged · Aged · Datasets as Topic · Artificial Intelligence · Aorta / diagnostic imaging
연구비
Institute of Information & communications Technology Planning & Evaluation (IITP), Korea No. 2022000972
참고문헌
17편