Echocardiographic Detection of Regional Wall Motion Abnormalities Using Artificial Intelligence Compared to Human Readers.

BACKGROUND: Although regional wall motion abnormality (RWMA) detection is foundational to transthoracic echocardiography, current methods are prone to interobserver variability. We aimed to develop a deep learning (DL) model for RWMA assessment and compare it to expert and novice readers. METHODS: We used 15,746 transthoracic echocardiography studies-including 25,529 apical videos-which were split into training, validation, and test datasets. A convolutional neural network was trained and validated using apical 2-, 3-, and 4-chamber videos to predict the presence of RWMA in 7 regions defined by coronary perfusion territories, using the ground truth derived from clinical transthoracic echocardiography reports. Within the test cohort, DL model accuracy was compared to 6 expert and 3 novice readers using F1 score evaluation, with the ground truth of RWMA defined by expert readers. Significance between the DL model and novices was assessed using the permutation test. RESULTS: Within the test cohort, the DL model accurately identified any RWMA with an area under the curve of 0.96 (0.92-0.98). The mean F1 scores of the experts and the DL model were numerically similar for 6 of 7 regions: anterior (86 vs 84), anterolateral (80 vs 74), inferolateral (83 vs 87), inferoseptal (86 vs 86), apical (88 vs 87), inferior (79 vs 81), and any RWMA (90 vs 94), respectively, while in the anteroseptal region, the F1 score of the DL model was lower than the experts (75 vs 89). Using F1 scores, the DL model outperformed both novices 1 (P = .002) and 2 (P = .02) for the detection of any RWMA. CONCLUSIONS: Deep learning provides accurate detection of RWMA, which was comparable to experts and outperformed a majority of novices. Deep learning may improve the efficiency of RWMA assessment and serve as a teaching tool for novices.

Digital reference objects for evaluating algorithm performance in MR image formation.

PURPOSE: Digital Reference Objects (DROs) are mathematical phantoms that can serve as a basis for evaluating MR image quality (IQ) in an objective way. Their main purpose is to facilitate the establishment of fully automated and perfectly reproducible IQ metrics to objectively compare different algorithms in MR image formation in a standardized manner. They also allow to re-build parts of standard phantoms. METHODS: We sample DROs directly in k-space, using analytical formulas for the continuous Fourier transform of primitive shapes. We demonstrate this DRO approach by applying a state-of-the-art CNN-based denoising algorithm that is robust to varying noise levels to noisy images of the resolution section of the well-known ACR phantom for IQ assessment, reconstructed from both measured and simulated k-space data. RESULTS: Applying the CNN-based denoising algorithm to the measured and simulated version of the ACR phantom resolution section produced virtually identical results, as confirmed by visual and quantitative comparison. CONCLUSIONS: DROs can help guide technology selection during the development of new algorithms in MR image formation, e.g., via deep learning. This could be an important step towards reproducible MR image formation.