Abstract

To investigate the performance of a deep learning-based algorithm for fully automated quantification of left ventricular (LV) volumes and function in cardiac MRI. We retrospectively analysed MR examinations of 50 patients (74% men, median age 57 years). The most common indications were known or suspected ischemic heart disease, cardiomyopathies or myocarditis. Fully automated analysis of LV volumes and function was performed using a deep learning-based algorithm. The analysis was subsequently corrected by a senior cardiovascular radiologist. Manual volumetric analysis was performed by two radiology trainees. Volumetric results were compared using Bland–Altman statistics and intra-class correlation coefficient. The frequency of clinically relevant differences was analysed using re-classification rates. The fully automated volumetric analysis was completed in a median of 8 s. With expert review and corrections, the analysis required a median of 110 s. Median time required for manual analysis was 3.5 min for a cardiovascular imaging fellow and 9 min for a radiology resident (p < 0.0001 for all comparisons). The correlation between fully automated results and expert-corrected results was very strong with intra-class correlation coefficients of 0.998 for end-diastolic volume, 0.997 for end-systolic volume, 0.899 for stroke volume, 0.972 for ejection fraction and 0.991 for myocardial mass (all p < 0.001). Clinically meaningful differences between fully automated and expert corrected results occurred in 18% of cases, comparable to the rate between the two manual readers (20%). Deep learning-based fully automated analysis of LV volumes and function is feasible, time-efficient and highly accurate. Clinically relevant corrections are required in a minority of cases.

Highlights

  • The quantification of left ventricular (LV) ejection fraction (EF) as a measure of global systolic LV function is clinically important in a wide spectrum of cardiac conditions

  • In order to derive end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and EF from Cardiac magnetic resonance (CMR) datasets, the epicardial and endocardial contours of the myocardium need to be defined for each short-axis slice in diastole and systole

  • The fully automated volumetric analysis required a median of 8.4 s to complete

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Summary

Introduction

The quantification of LV ejection fraction (EF) as a measure of global systolic LV function is clinically important in a wide spectrum of cardiac conditions. Precise quantification of EF is important for the indication of implantable cardioverter-defibrillators or cardiac resynchronization therapy in both ischemic and nonischemic heart disease [6]. Cardiac magnetic resonance (CMR) imaging is established as the clinical gold standard for the evaluation of left. The International Journal of Cardiovascular Imaging (2020) 36:2239–2247 ventricular (LV) volumes, ejection fraction and myocardial mass [5, 7]. In order to derive end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and EF from CMR datasets, the epicardial and endocardial contours of the myocardium need to be defined for each short-axis slice in diastole and systole. Many vendors offer software tools for semi-automated volumetric analysis

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