Machine learning based automated dynamic quantification of left heart chamber volumes. (9th October 2018)

• Record Type: Journal Article
• Authors: Narang, Akhil; Mor-Avi, Victor; Prado, Aldo; Volpato, Valentina; Prater, David; Tamborini, Gloria; Fusini, Laura; Pepi, Mauro; Goyal, Neha; Addetia, Karima; Gonçalves, Alexandra; Patel, Amit R; Lang, Roberto M
• Is Part Of: European heart journal. Volume 20:Number 5(2019)
• Page Start: 541
• Page End: 549
• Publication Date: 2018-10-09
• Subjects: 3D echocardiography -- cardiac chamber quantification -- automation -- machine learning; Cardiovascular system -- Imaging -- Periodicals; Heart -- Imaging -- Periodicals; 616.10754
• DOI: 10.1093/ehjci/jey137
• Languages: English
• ISSNs: 2047-2404

Abstract

Abstract: Aims: Studies have demonstrated the ability of a new automated algorithm for volumetric analysis of 3D echocardiographic (3DE) datasets to provide accurate and reproducible measurements of left ventricular and left atrial (LV, LA) volumes at end-systole and end-diastole. Recently, this methodology was expanded using a machine learning (ML) approach to automatically measure chamber volumes throughout the cardiac cycle, resulting in LV and LA volume–time curves. We aimed to validate ejection and filling parameters obtained from these curves by comparing them to independent well-validated reference techniques. Methods and results: We studied 20 patients referred for cardiac magnetic resonance (CMR) examinations, who underwent 3DE imaging the same day. Volume–time curves were obtained for both LV and LA chambers using the ML algorithm (Philips HeartModel), and independently conventional 3DE volumetric analysis (TomTec), and CMR images (slice-by-slice, frame-by-frame manual tracing). Automatically derived LV and LA volumes and ejection/filling parameters were compared against both reference techniques. Minor manual correction of the automatically detected LV and LA borders was needed in 4/20 and 5/20 cases, respectively. Time required to generate volume–time curves was 35 ± 17 s using ML algorithm, 3.6 ± 0.9 min using conventional 3DE analysis, and 96 ± 14 min using CMR. Volume–time curves obtained by all three techniques were similar in shape and magnitude. In both comparisons, ejection/filling parameters showed no significant inter-technique differences. Bland–Altman analysis confirmed small biases, despite wide limits of agreement. Conclusion: The automated ML algorithm can quickly measure dynamic LV and LA volumes and accurately analyse ejection/filling parameters. Incorporation of this algorithm into the clinical workflow may increase the utilization of 3DE imaging.