A fused deep learning architecture for viewpoint classification of echocardiography

This study extends the state of the art of deep learning convolutional neural network (CNN) to the classification of video images of echocardiography, aiming at assisting clinicians in diagnosis of heart diseases. Specifically, the architecture of neural networks is established by embracing hand-crafted features within a data-driven learning framework, incorporating both spatial and temporal information sustained by the video images of the moving heart and giving rise to two strands of two-dimensional convolutional neural network (CNN). In particular, the acceleration measurement along the time direction at each point is calculated using dense optical flow technique to represent temporal motion information. Subsequently, the fusion of both networks is conducted via linear integrations of the vectors of class scores obtained from each of the two networks. As a result, this architecture maintains the best classification results for eight viewpoint categories of echo videos with 92.1% accuracy rate whereas 89.5% is achieved using only single spatial CNN network. When concerning only three primary locations, 98% of accuracy rate is realised. In addition, comparisons with a number of well-known hand-engineered approaches are also performed, including 2D KAZE, 2D KAZE with Optical Flow, 3D KAZA, Optical Flow, 2D SIFT and 3D SIFT, which delivers accuracy rate of 89.4%, 84.3%, 87.9%, 79.4%, 83.8% and 73.8% respectively

Fast and accurate classification of echocardiograms using deep learning

Echocardiography is essential to modern cardiology. However, human interpretation limits high throughput analysis, limiting echocardiography from reaching its full clinical and research potential for precision medicine. Deep learning is a cutting-edge machine-learning technique that has been useful in analyzing medical images but has not yet been widely applied to echocardiography, partly due to the complexity of echocardiograms' multi view, multi modality format. The essential first step toward comprehensive computer assisted echocardiographic interpretation is determining whether computers can learn to recognize standard views. To this end, we anonymized 834,267 transthoracic echocardiogram (TTE) images from 267 patients (20 to 96 years, 51 percent female, 26 percent obese) seen between 2000 and 2017 and labeled them according to standard views. Images covered a range of real world clinical variation. We built a multilayer convolutional neural network and used supervised learning to simultaneously classify 15 standard views. Eighty percent of data used was randomly chosen for training and 20 percent reserved for validation and testing on never seen echocardiograms. Using multiple images from each clip, the model classified among 12 video views with 97.8 percent overall test accuracy without overfitting. Even on single low resolution images, test accuracy among 15 views was 91.7 percent versus 70.2 to 83.5 percent for board-certified echocardiographers. Confusional matrices, occlusion experiments, and saliency mapping showed that the model finds recognizable similarities among related views and classifies using clinically relevant image features. In conclusion, deep neural networks can classify essential echocardiographic views simultaneously and with high accuracy. Our results provide a foundation for more complex deep learning assisted echocardiographic interpretation.Comment: 31 pages, 8 figure

Deep Learning in Cardiology

The medical field is creating large amount of data that physicians are unable to decipher and use efficiently. Moreover, rule-based expert systems are inefficient in solving complicated medical tasks or for creating insights using big data. Deep learning has emerged as a more accurate and effective technology in a wide range of medical problems such as diagnosis, prediction and intervention. Deep learning is a representation learning method that consists of layers that transform the data non-linearly, thus, revealing hierarchical relationships and structures. In this review we survey deep learning application papers that use structured data, signal and imaging modalities from cardiology. We discuss the advantages and limitations of applying deep learning in cardiology that also apply in medicine in general, while proposing certain directions as the most viable for clinical use.Comment: 27 pages, 2 figures, 10 table

Analyzing MRI scans to detect glioblastoma tumor using hybrid deep belief networks

Abstract Glioblastoma (GBM) is a stage 4 malignant tumor in which a large portion of tumor cells are reproducing and dividing at any moment. These tumors are life threatening and may result in partial or complete mental and physical disability. In this study, we have proposed a classification model using hybrid deep belief networks (DBN) to classify magnetic resonance imaging (MRI) for GBM tumor. DBN is composed of stacked restricted Boltzmann machines (RBM). DBN often requires a large number of hidden layers that consists of large number of neurons to learn the best features from the raw image data. Hence, computational and space complexity is high and requires a lot of training time. The proposed approach combines DTW with DBN to improve the efficiency of existing DBN model. The results are validated using several statistical parameters. Statistical validation verifies that the combination of DTW and DBN outperformed the other classifiers in terms of training time, space complexity and classification accuracy

Automated and Interpretable Patient ECG Profiles for Disease Detection, Tracking, and Discovery

The electrocardiogram or ECG has been in use for over 100 years and remains the most widely performed diagnostic test to characterize cardiac structure and electrical activity. We hypothesized that parallel advances in computing power, innovations in machine learning algorithms, and availability of large-scale digitized ECG data would enable extending the utility of the ECG beyond its current limitations, while at the same time preserving interpretability, which is fundamental to medical decision-making. We identified 36,186 ECGs from the UCSF database that were 1) in normal sinus rhythm and 2) would enable training of specific models for estimation of cardiac structure or function or detection of disease. We derived a novel model for ECG segmentation using convolutional neural networks (CNN) and Hidden Markov Models (HMM) and evaluated its output by comparing electrical interval estimates to 141,864 measurements from the clinical workflow. We built a 725-element patient-level ECG profile using downsampled segmentation data and trained machine learning models to estimate left ventricular mass, left atrial volume, mitral annulus e' and to detect and track four diseases: pulmonary arterial hypertension (PAH), hypertrophic cardiomyopathy (HCM), cardiac amyloid (CA), and mitral valve prolapse (MVP). CNN-HMM derived ECG segmentation agreed with clinical estimates, with median absolute deviations (MAD) as a fraction of observed value of 0.6% for heart rate and 4% for QT interval. Patient-level ECG profiles enabled quantitative estimates of left ventricular and mitral annulus e' velocity with good discrimination in binary classification models of left ventricular hypertrophy and diastolic function. Models for disease detection ranged from AUROC of 0.94 to 0.77 for MVP. Top-ranked variables for all models included known ECG characteristics along with novel predictors of these traits/diseases.Comment: 13 pages, 6 figures, 1 Table + Supplemen

Neural architecture search of echocardiography view classifiers

Purpose: Echocardiography is the most commonly used modality for assessing the heart in clinical practice. In an echocardiographic exam, an ultrasound probe samples the heart from different orientations and positions, thereby creating different viewpoints for assessing the cardiac function. The determination of the probe viewpoint forms an essential step in automatic echocardiographic image analysis. Approach: In this study, convolutional neural networks are used for the automated identification of 14 different anatomical echocardiographic views (larger than any previous study) in a dataset of 8732 videos acquired from 374 patients. Differentiable architecture search approach was utilized to design small neural network architectures for rapid inference while maintaining high accuracy. The impact of the image quality and resolution, size of the training dataset, and number of echocardiographic view classes on the efficacy of the models were also investigated. Results: In contrast to the deeper classification architectures, the proposed models had significantly lower number of trainable parameters (up to 99.9% reduction), achieved comparable classification performance (accuracy 88.4% to 96%, precision 87.8% to 95.2%, recall 87.1% to 95.1%) and real-time performance with inference time per image of 3.6 to 12.6 ms. Conclusion: Compared with the standard classification neural network architectures, the proposed models are faster and achieve comparable classification performance. They also require less training data. Such models can be used for real-time detection of the standard views