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BMC Medical Imaging
Article . 2024 . Peer-reviewed
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BMC Medical Imaging
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A deep learning based method for left ventricular strain measurements: repeatability and accuracy compared to experienced echocardiographers

repeatability and accuracy compared to experienced echocardiographers
Authors: Rogstadkjernet, Magnus; Zha, Sigurd Z.; Klæboe, Lars G.; Larsen, Camilla K.; Aalen, John M.; Scheirlynck, Esther; Singstad, Bjørn-Jostein; +7 Authors

A deep learning based method for left ventricular strain measurements: repeatability and accuracy compared to experienced echocardiographers

Abstract

Abstract Background Speckle tracking echocardiography (STE) provides quantification of left ventricular (LV) deformation and is useful in the assessment of LV function. STE is increasingly being used clinically, and every effort to simplify and standardize STE is important. Manual outlining of regions of interest (ROIs) is labor intensive and may influence assessment of strain values. Purpose We hypothesized that a deep learning (DL) model, trained on clinical echocardiographic exams, can be combined with a readily available echocardiographic analysis software, to automate strain calculation with comparable fidelity to trained cardiologists. Methods Data consisted of still frame echocardiographic images with cardiologist-defined ROIs from 672 clinical echocardiographic exams from a university hospital outpatient clinic. Exams included patients with ischemic heart disease, heart failure, valvular disease, and conduction abnormalities, and some healthy subjects. An EfficientNetB1-based architecture was employed, and different techniques and properties including data set size, data quality, augmentations, and transfer learning were evaluated. DL predicted ROIs were reintroduced into commercially available echocardiographic analysis software to automatically calculate strain values. Results DL-automated strain calculations had an average absolute difference of 0.75 (95% CI 0.58–0.92) for global longitudinal strain (GLS), and 1.16 (95% CI 1.03–1.29) for single-projection longitudinal strain (LS), compared to operators. A Bland–Altman plot revealed no obvious bias, though there were fewer outliers in the lower average LS ranges. Techniques and data properties yielded no significant increase/decrease in performance. Conclusion The study demonstrates that DL-assisted, automated strain measurements are feasible, and provide results within interobserver variation. Employing DL in echocardiographic analyses could further facilitate adoption of STE parameters in clinical practice and research, and improve reproducibility.

Keywords

Male, Adult, Artificial intelligence, Heart Ventricles, 610, Heart Ventricles/diagnostic imaging, Echocardiography/methods, Ventricular Function, Left, Automation, Deep Learning, Medical technology, Humans, R855-855.5, Aged, Research, Speckle-tracking echocardiography, Reproducibility of Results, 600, Strain rate imaging, Deep learning, Middle Aged, Echocardiography, Female, reproducibility of results, Ventricular Function, Left/physiology

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
1
Average
Average
Average
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gold