Abstract

In transthoracic echocardiographic (TTE) examination, it is essential to identify the cardiac views accurately. Computer-aided recognition is expected to improve the accuracy of cardiac views of the TTE examination, particularly when obtained by non-trained providers. A new method for automatic recognition of cardiac views is proposed consisting of three processes. First, a spatial transform network is performed to learn cardiac shape changes during a cardiac cycle, which reduces intra-class variability. Second, a channel attention mechanism is introduced to adaptively recalibrate channel-wise feature responses. Finally, the structured signals by the similarities among cardiac views are transformed into the graph-based image embedding, which acts as unsupervised regularization constraints to improve the generalization accuracy. The proposed method is trained and tested in 171792 cardiac images from 584 subjects. The overall accuracy of the proposed method on cardiac image classification is 99.10%, and the mean AUC is 99.36%, better than known methods. Moreover, the overall accuracy is 97.73%, and the mean AUC is 98.59% on an independent test set with 37,883 images from 100 subjects. The proposed automated recognition model achieved comparable accuracy with true cardiac views, and thus can be applied clinically to help find standard cardiac views.

Highlights

  • Accepted: 24 June 2021Transthoracic echocardiography (TTE) is the most commonly used cardiac imaging tool, which provides comprehensive observations of the cardiac structures and functions, and assists in the diagnosis and management of heart failure, ischemia, valve disease, and congenital abnormalities, among others [1,2]

  • All the cardiac images came from two hospitals, Shaanxi Provincial People’s Hospital (SXPPH) and the First Affiliated Hospital of Xi’an Jiaotong University (XJTUFAH)

  • The experimental design was approved by the Institutional Review Board (IRB), and all subjects were informed of the experimental contents and risks

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Summary

Introduction

Transthoracic echocardiography (TTE) is the most commonly used cardiac imaging tool, which provides comprehensive observations of the cardiac structures and functions, and assists in the diagnosis and management of heart failure, ischemia, valve disease, and congenital abnormalities, among others [1,2]. Echocardiography was a highly specialized diagnostic tool performed only by professionally trained experts, and it has been rapidly extended to other medical specialties, especially in primary and emergency care settings [3], because it is non-invasive, cost-effective, and convenient. There has been concern that the level of training of medical staff performing echocardiography in other medical specialties is not sufficient to yield accurate and reliable results. Almost all examinations in echocardiography are based on the locations of the heart views. The training to find standard views is time-consuming and requires expert support [5]

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