Abstract 11702: Development of Artificial Intelligence-Based Slow-Motion Echocardiography and Clinical Usefulness for Evaluating Regional Wall Motion Abnormalities

Abstract

Introduction: Improvement in accuracy and image readability of stress echocardiography needs to be addressed, given that the accuracy depends on the physicians’ experience and image quality. The study aimed to develop an artificial intelligence (AI) based slow-motion echocardiography by inter-image interpolation and evaluate the clinical usefulness for detecting regional wall motion abnormalities (RWMAs). Methods: An AI-based image interpolation pipeline was developed with the optical flow calculation between echocardiographic images and predicting in-between images. In a cohort of patients with RWMA (n=25) and healthy volunteers (n=25), the accuracy for detecting RWMAs and image-reliabilities among four cardiologists was evaluated using slow-motion and conventional exercise stress echocardiography. Results: The development of slow-motion echocardiography were successfully performed at any arbitrary-time steps (e.g., 0.125x, 0.25x, and 0.5x). The accuracy for detecting RWMAs was numerically improved, while not statistically significant (87.5% in slow-motion echocardiography vs 81.0% in conventional stress echocardiography, odds ratio: 1.43 (95% confidence interval 0.78-2.62, p=0.25). Inter-reader agreement analysis demonstrated the level of agreements (Fleiss’s Kappa) for detecting RWMAs was 0.66 (95%CI: 0.55-0.77) in slow-motion echocardiography, and 0.53 (95%CI: 0.42-0.65) in conventional stress echocardiography. As for the four-point scale subjectively-evaluated image readability, the mean score was significantly improved using slow-motion echocardiography (2.11±0.73vs 1.70±0.78, p<0.001). Conclusions: Slow-motion echocardiography was successfully developed. There was no significant improvement in the accuracy for detecting RWMAs using the developed slow-motion echocardiography, while the image readability and inter-reader agreement were improved.