A deep learning approach for the automatic recognition of prosthetic mitral valve in echocardiographic images

Abstract

The first step in the automatic evaluation of the cardiac prosthetic valve is the recognition of such valves in echocardiographic images. This research surveyed whether a deep convolutional neural network (DCNN) could improve the recognition of prosthetic mitral valve in conventional 2D echocardiographic images. An efficient intervention to decrease the misreading rate of the prosthetic mitral valve is required for non-expert cardiologists. This intervention could serve as a section of a fully-automated analysis chain, alleviate the cardiologist's workload, and improve precision and time management, especially in an emergent situation. Additionally, it might be suitable for pre-labeling large databases of unclassified images. We, therefore, introduce a large publicly-available annotated dataset for the purpose of prosthetic mitral valve recognition. We utilized 2044 comprehensive non-stress transthoracic echocardiographic studies. Totally, 1597 patients had natural mitral valves and 447 patients had prosthetic valves. Each case contained 1 cycle of echocardiographic images from the apical 4-chamber (A4C) and the parasternal long-axis (PLA) views. Thirteen versions of the state-of-the-art models were independently trained, and the ensemble predictions were performed using those versions. For the recognition of prosthetic mitral valves from natural mitral valves, the area under the receiver-operating characteristic curve (AUC) made by the deep learning algorithm was similar to that made by cardiologists (0.99). In this research, EfficientNetB3 architecture in the A4C view and the EfficientNetB4 architecture in the PLA view were the best models among the other pre-trained DCNN models.