Application of a machine learning contouring tool for the evaluation of left ventricular strain in clinical practice
Notice bibliographique
Résumé
Abstract Funding Acknowledgements Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): AK has been funded by the Egyptian cultural centre and educational bureau of the Egyptian embassy in London and the Ministry of higher education in Egypt. SEP acknowledges support from the “SmartHeart” EPSRC programme grant (www.nihr.ac.uk; EP/P001009/1) and the London Medical Imaging and AI Centre for Value-Based Healthcare. This new centre is one of the UK Centres supported by a £50m investment from the Data to Early Diagnosis and Precision Medicine strand of the government’s Industrial Strategy Challenge Fund, managed and delivered by UK Research and Innovation (UKRI). SEP acknowledges support from the CAP-AI programme, London’s first AI enabling programme focused on stimulating growth in the capital’s AI Sector. CAP-AI is led by Capital Enterprise in partnership with Barts Health NHS Trust and Digital Catapult and is funded by the European Regional Development Fund and Barts Charity. SEP also acts as a paid consultant to Circle Cardiovascular Imaging Inc., Calgary, Canada and Servier onbehalf Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, London, UK Background Manual contouring of cardiovascular magnetic resonance (CMR) cine images remains common practice and the reference standard for left ventricular (LV) volumes and mass evaluation. However, it is time-consuming and machine learning (ML) may significantly reduce the time required for contouring. Accurate LV contours are the basis for reliable LV strain analysis using tissue tracking. Purpose To assess the impact of a ML contouring tool alone versus expert adjusted contours on LV strain. Methods We retrospectively selected 402 CMR studies with diagnoses of myocardial infarction (n = 108), myocarditis (n = 130) and healthy controls (n = 164) from the Barts BioResource between January 2015 to June 2018. CMR examinations were obtained using 1.5T and 3T scanners (Siemens Healthineers, Germany). We excluded 32 cases due to phase inconsistency between short (SAX) and long axes (LAX) cine images or suboptimal cine image quality. For the remaining 370 cases, steady state free precession cine images for LAX and SAX were analysed by the ML contouring tool (using CVI42 research prototype software 5.11). Manual expert adjustment for the contours was done for each case if considered suboptimal for strain analysis in the reference end-diastolic phase. Strain results from ML and expert adjusted ML methods were compared for strain agreement. Times taken by these methods were recorded and compared against the time taken for standard manual contouring. Results SAX and LAX derived strains by ML and expert adjusted ML methods showed good agreement by Bland-Altman analysis (Figure 1) with excellent coefficient of concordance using Kendall W which is 0.98 for global SAX, radial and circumferential strains (mean difference(MD) = -1.7% (lower and upper limits of agreement (UL,LL) -6.6,3.2), MD = 0.5% (-1.0,2.1)) and is 0.95 for global LAX derived strain (radial and longitudinal, MD = 0.7% (UL,LL -8.7 ,7.4),MD= 0.2% (-1.9,2.5), respectively). Time taken for adjustment of ML contours was significantly shorter than manual contouring (1.35 minutes vs 8.0 minutes, around 590% time saving in ML adjusted method). Conclusions ML contouring compared to expert manual adjustment has a clinically reasonable agreement when used for measuring LV strain. Also, using the ML tool with expert adjustment shows significant time saving for analysis and reporting time compared to entirely manual analysis, favouring its application in routine clinical practice. Abstract Figure.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,023 | 0,018 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».