Abstract
Automatic boundary detection of 4D ultrasound (4DUS) cardiac data is a promising yet challenging application at the intersection of machine learning and medicine. Using recently developed murine 4DUS cardiac imaging data, we demonstrate here a set of three machine learning models that predict left ventricular wall kinematics along both the endo- and epi-cardial boundaries. Each model is fundamentally built on three key features: (1) the projection of raw US data to a lower dimensional subspace, (2) a smoothing spline basis across time, and (3) a strategic parameterization of the left ventricular boundaries. Model 1 is constructed such that boundary predictions are based on individual short-axis images, regardless of their relative position in the ventricle. Model 2 simultaneously incorporates parallel short-axis image data into their predictions. Model 3 builds on the multi-slice approach of model 2, but assists predictions with a single ground-truth position at end-diastole. To assess the performance of each model, Monte Carlo cross validation was used to assess the performance of each model on unseen data. For predicting the radial distance of the endocardium, models 1, 2, and 3 yielded average R2 values of 0.41, 0.49, and 0.71, respectively. Monte Carlo simulations of the endocardial wall showed significantly closer predictions when using model 2 versus model 1 at a rate of 48.67%, and using model 3 versus model 2 at a rate of 83.50%. These finding suggest that a machine learning approach where multi-slice data are simultaneously used as input and predictions are aided by a single user input yields the most robust performance. Subsequently, we explore the how metrics of cardiac kinematics compare between ground-truth contours and predicted boundaries. We observed negligible deviations from ground-truth when using predicted boundaries alone, except in the case of early diastolic strain rate, providing confidence for the use of such machine learning models for rapid and reliable assessments of murine cardiac function. To our knowledge, this is the first application of machine learning to murine left ventricular 4DUS data. Future work will be needed to strengthen both model performance and applicability to different cardiac disease models.
Highlights
As heart disease remains the number one cause of death in the United States [1], echocardiography remains an integral tool to the proper diagnosis and prognosis of abnormal cardiac function
We demonstrate here the first application of machine learning to the prediction of left-ventricular wall boundaries in murine 4D ultrasound (4DUS) image data
Our results demonstrate notably better agreement between ground-truth and predicted locations when using a model based on a combination of parallel short-axis images compared to treating all images separately
Summary
As heart disease remains the number one cause of death in the United States [1], echocardiography remains an integral tool to the proper diagnosis and prognosis of abnormal cardiac function. While machine learning has demonstrated notable successes in ventricle segmentation on 4D cardiac MRI data [18,19,20], epicardial fat segmentation in Computed Tomography (CT) data [21,22], and even boundary detection in clinical 2DUS echocardiography data [10], applications to murine 4DUS data remain limited [12]. This is in part due to unique challenges presented by 4DUS data. The high dimensionality in combination with the relatively small sample sizes commonly seen in medical applications, of which our dataset is no exception, presents even further challenges
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