Abstract
Although deep learning has been explored extensively for computer‐aided medical imaging diagnosis in human medicine, very little has been done in veterinary medicine. The goal of this retrospective, pilot project was to apply the deep learning artificial intelligence technique using thoracic radiographs for detection of canine left atrial enlargement and compare results with those of veterinary radiologist interpretations. Seven hundred ninety‐two right lateral radiographs from canine patients with thoracic radiographs and contemporaneous echocardiograms were used to train, validate, and test a convolutional neural network algorithm. The accuracy, sensitivity, and specificity for determination of left atrial enlargement were then compared with those of board‐certified veterinary radiologists as recorded on radiology reports. The accuracy, sensitivity, and specificity were 82.71%, 68.42%, and 87.09%, respectively, using an accuracy driven variant of the convolutional neural network algorithm and 79.01%, 73.68%, and 80.64%, respectively, using a sensitivity driven variant. By comparison, accuracy, sensitivity, and specificity achieved by board‐certified veterinary radiologists was 82.71%, 68.42%, and 87.09%, respectively. Although overall accuracy of the accuracy driven convolutional neural network algorithm and veterinary radiologists was identical, concordance between the two approaches was 85.19%. This study documents proof‐of‐concept for application of deep learning techniques for computer‐aided diagnosis in veterinary medicine.
Highlights
10% of canine patients presented to general veterinary practitioners have heart disease.[1]
Dogs with myxomatous mitral valve disease initially develop degenerative lesions of the mitral valve that can lead to left atrial enlargement and congestive heart failure in some dogs
Patients were included in the investigation if the radiographic examination included a right lateral view and the radiographic and echocardiographic examinations included a formal report reviewed by a board-certified veterinary radiologist (American College of Veterinary Radiology) or veterinary cardiologist (American College of Veterinary Internal Medicine), respectively
Summary
10% of canine patients presented to general veterinary practitioners have heart disease.[1]. A presumptive diagnosis of myxomatous mitral valve disease is often reached based on signalment, a left apical systolic murmur, and characteristic thoracic radiographic features. It is confirmed with an echocardiographic examination. The clinically applicable methods to identify left atrial enlargement from thoracic radiographs include detection of characteristic cardiac margin changes, carinal elevation, subjective mainstem bronchial widening, bifurcation angle measurements, and vertebral heart score estimations.[8,9,10] None of these, are considered consistently accurate, and radiographic interpretation of left atrial enlargement has been shown to be inconsistent, when performed by those without advanced training.[11]
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