Deep Learning Formulation of ECGI for Data-driven Integration of Spatiotemporal Correlations and Imaging Information

International audienceThe challenge of non-invasive Electrocardiographic Imaging (ECGI) is to recreate the electrical activity of the heart using body surface potentials. Specifically, there are numerical difficulties due to the ill-posed nature of the problem. We propose a novel method based on Conditional Variational Autoencoders using Deep generative Neural Networks to overcome this challenge. By conditioning the electrical activity on heart shape and electrical potentials, our model is able to generate activation maps with good accuracy on simulated data (mean square error, MSE = 0.095). This method differs from other formulations because it naturally takes into account spatio-temporal correlations as well as the imaging substrate through convolutions and conditioning. We believe these features can help improving ECGI results

Deep Learning Formulation of ECGI Integrating Image & Signal Information with Data-driven Regularisation

International audienceAims: Electrocardiographic Imaging (ECGI) is a promising tool to map the electrical activity of the heart non-invasively using body surface potentials (BSP). However, it is still challenging due to the mathematically ill-posed nature of the inverse problem to solve. Novel approaches leveraging progress in artificial intelligence could alleviate these difficulties. Methods: We propose a Deep Learning (DL) formulation of ECGI in order to learn the statistical relation between BSP and cardiac activation. The presented method is based on Conditional Variational Autoencoders (CVAE) using deep generative neural networks. To quantify the accuracy of this method, we simulated activation maps and BSP data on six cardiac anatomies. Results: We evaluated our model by training it on five different cardiac anatomies (5 000 activation maps) and by testing it on a new patient anatomy over 200 activation maps. Due to the probabilistic property of our method, we predicted 10 distinct activation maps for each BSP data. The proposed method is able to generate volumetric activation maps with a good accuracy on the simulated data: the mean absolute error is 9.40 ms with 2.16 ms standard deviation on this testing set. Conclusion: The proposed formulation of ECGI enables to naturally include imaging information in the estimation of cardiac electrical activity from body surface potential. It naturally takes into account all the spatio-temporal correlations present in the data. We believe these features can help improve ECGI results

Learning Geometry-Dependent and Physics-Based Inverse Image Reconstruction

Deep neural networks have shown great potential in image reconstruction problems in Euclidean space. However, many reconstruction problems involve imaging physics that are dependent on the underlying non-Euclidean geometry. In this paper, we present a new approach to learn inverse imaging that exploit the underlying geometry and physics. We first introduce a non-Euclidean encoding-decoding network that allows us to describe the unknown and measurement variables over their respective geometrical domains. We then learn the geometry-dependent physics in between the two domains by explicitly modeling it via a bipartite graph over the graphical embedding of the two geometry. We applied the presented network to reconstructing electrical activity on the heart surface from body-surface potential. In a series of generalization tasks with increasing difficulty, we demonstrated the improved ability of the presented network to generalize across geometrical changes underlying the data in comparison to its Euclidean alternatives

The Application of Computer Techniques to ECG Interpretation

This book presents some of the latest available information on automated ECG analysis written by many of the leading researchers in the field. It contains a historical introduction, an outline of the latest international standards for signal processing and communications and then an exciting variety of studies on electrophysiological modelling, ECG Imaging, artificial intelligence applied to resting and ambulatory ECGs, body surface mapping, big data in ECG based prediction, enhanced reliability of patient monitoring, and atrial abnormalities on the ECG. It provides an extremely valuable contribution to the field

Personnalisation basée sur l'imagerie de modèles cardiaques électrophysiologiques pour la planification du traitement de la tachycardie ventriculaire

Acute infarct survival rates have drastically improved over the last decades, mechanically increasing chronic infarct related affections.Among these affections, ischaemic ventricular tachycardia (VT) is a particularly serious arrhythmia that can lead to the often lethal ventricular fibrillation. VT can be treated by radio frequency ablation of the arrhythmogenic substrate.The first phase of this long and risky interventional cardiology procedure is an electrophysiological (EP) exploration of the heart.This phase aims at localising the ablation targets, notably by inducing the arrhythmia in a controlled setting. In this work we propose to re-create this exploration phase in silico, by personalising cardiac EP models.We show that key information about infarct scar location and heterogeneity can be automatically obtained by a deep learning-based automated segmentation of the myocardium on computed tomography (CT) images.Our goal is to use this information to run patient-specific simulations of depolarisation wave propagation in the myocardium, mimicking the interventional cardiology exploration phase.We start by studying the relationship between the depolarisation wave propagation velocity and the left ventricular wall thickness to personalise an Eikonal model, an approach that can successfully reproduce periodic activation maps of the left ventricle recorded during VT.We then propose efficient algorithms to detect the repolarisation wave on unipolar electrograms (UEG), that we use to analyse the UEGs embedded in such intra-cardiac recordings.Thanks to a multimodal registration between these recordings and CT images, we establish relationships between action potential durations/restitution properties and left ventricular wall thickness.These relationships are finally used to parametrise a reaction-diffusion model able to reproduce interventional cardiologists' induction protocols that trigger realistic and documented VTs. inteinterventional cardiologists' induction protocols that trigger realistic and documented VTs.La survie lors de la phase aiguë de l'infarctus du myocarde a énormément progressé au cours des dernières décennies, augmentant ainsi la mortalité des affections liées à l'infarctus chronique.Parmi ces pathologies, la tachycardie ventriculaire (TV) est une arythmie particulièrement grave qui peut conduire à la fibrillation ventriculaire, souvent fatale.La TV peut être traitée par ablation par radio-fréquences du substrat arythmogène.La première phase de cette procédure, longue et risquée, est une exploration électrophysiologique (EP) du cœur consistant à déterminer les cibles de cette ablation, notamment en provoquant l'arythmie dans un environnement contrôléDans cette thèse, nous proposons de re-créer in silico cette phase exploratoire, en personnalisation des modèles cardiaques EP.Nous montrons que des informations clefs à propos de la localisation et de l'hétérogénéité de la cicatrice d'infarctus peuvent être obtenues automatiquement par une segmentation d'images tomodensitométriques (TDM) utilisant un réseau de neurones artificiels.Notre but est alors d'utiliser ces informations pour réaliser des simulations spécifiques à un patient de la propagation de l'onde de dépolarisation dans le myocarde, reproduisant la phase exploratoire décrite plus haut.Nous commençons par étudier la relation entre la vitesse de l'onde de dépolarisation et l'épaisseur du ventricule gauche, relation qui permet de personnaliser un modèle EP Eikonal; cette approche permet fr reproduire des cartes d'activations périodiques du ventricule gauche obtenues durant des TV.Nous proposons ensuite des algorithmes efficaces pour détecter l'onde de repolarisation sur les électrogrammes unipolaires (EGU), que nous utilisons pour analyser les EGU contenus dans les enregistrements intra-cardiaques à notre disposition.Grâce à un recalage multimodal entre ces enregistrements et des images TDM, nous établissons des relations entre durées de potentiels d'action (DPA)/propriétés de restitutions de DPA et épaisseur du ventricule gauche.Enfin, ces relations sont utilisés pour paramétrer un modèle de réaction-diffusion capable de reproduire fidèlement les protocoles d'induction des cardiologues interventionnels qui provoquent des TV réalistes et documentées

Le recalage robuste d’images médicales et la modélisation du mouvement basée sur l’apprentissage profond

This thesis presents new computational tools for quantifying deformations and motion of anatomical structures from medical images as required by a large variety of clinical applications. Generic deformable registration tools are presented that enable deformation analysis useful for improving diagnosis, prognosis and therapy guidance. These tools were built by combining state-of-the-art medical image analysis methods with cutting-edge machine learning methods.First, we focus on difficult inter-subject registration problems. By learning from given deformation examples, we propose a novel agent-based optimization scheme inspired by deep reinforcement learning where a statistical deformation model is explored in a trial-and-error fashion showing improved registration accuracy. Second, we develop a diffeomorphic deformation model that allows for accurate multiscale registration and deformation analysis by learning a low-dimensional representation of intra-subject deformations. The unsupervised method uses a latent variable model in form of a conditional variational autoencoder (CVAE) for learning a probabilistic deformation encoding that is useful for the simulation, classification and comparison of deformations.Third, we propose a probabilistic motion model derived from image sequences of moving organs. This generative model embeds motion in a structured latent space, the motion matrix, which enables the consistent tracking of structures and various analysis tasks. For instance, it leads to the simulation and interpolation of realistic motion patterns allowing for faster data acquisition and data augmentation.Finally, we demonstrate the importance of the developed tools in a clinical application where the motion model is used for disease prognosis and therapy planning. It is shown that the survival risk for heart failure patients can be predicted from the discriminative motion matrix with a higher accuracy compared to classical image-derived risk factors.Cette thèse présente de nouveaux outils informatiques pour quantifier les déformations et le mouvement de structures anatomiques à partir d’images médicales dans le cadre d’une grande variété d’applications cliniques. Des outils génériques de recalage déformable sont présentés qui permettent l’analyse de la déformation de tissus anatomiques pour améliorer le diagnostic, le pronostic et la thérapie. Ces outils combinent des méthodes avancées d’analyse d’images médicales avec des méthodes d’apprentissage automatique performantes.Dans un premier temps, nous nous concentrons sur les problèmes de recalages inter-sujets difficiles. En apprenant à partir d’exemples de déformation donnés, nous proposons un nouveau schéma d’optimisation basé sur un agent inspiré de l’apprentissage par renforcement profond dans lequel un modèle de déformation statistique est exploré de manière itérative montrant une précision améliorée de recalage. Dans un second temps, nous développons un modèle de déformation difféomorphe qui permet un recalage multi-échelle précis et une analyse de déformation en apprenant une représentation de faible dimension des déformations intra-sujet. La méthode non supervisée utilise un modèle de variable latente sous la forme d’un autoencodeur variationnel conditionnel (CVAE) pour apprendre une représentation probabiliste des déformations qui est utile pour la simulation, la classification et la comparaison des déformations. Troisièmement, nous proposons un modèle de mouvement probabiliste dérivé de séquences d’images d’organes en mouvement. Ce modèle génératif décrit le mouvement dans un espace latent structuré, la matrice de mouvement, qui permet le suivi cohérent des structures ainsi que l’analyse du mouvement. Ainsi cette approche permet la simulation et l’interpolation de modèles de mouvement réalistes conduisant à une acquisition et une augmentation des données plus rapides.Enfin, nous démontrons l’intérêt des outils développés dans une application clinique où le modèle de mouvement est utilisé pour le pronostic de maladies et la planification de thérapies. Il est démontré que le risque de survie des patients souffrant d’insuffisance cardiaque peut être prédit à partir de la matrice de mouvement discriminant avec une précision supérieure par rapport aux facteurs de risque classiques dérivés de l’image

Multidisciplinary perspectives on Artificial Intelligence and the law

This open access book presents an interdisciplinary, multi-authored, edited collection of chapters on Artificial Intelligence (‘AI’) and the Law. AI technology has come to play a central role in the modern data economy. Through a combination of increased computing power, the growing availability of data and the advancement of algorithms, AI has now become an umbrella term for some of the most transformational technological breakthroughs of this age. The importance of AI stems from both the opportunities that it offers and the challenges that it entails. While AI applications hold the promise of economic growth and efficiency gains, they also create significant risks and uncertainty. The potential and perils of AI have thus come to dominate modern discussions of technology and ethics – and although AI was initially allowed to largely develop without guidelines or rules, few would deny that the law is set to play a fundamental role in shaping the future of AI. As the debate over AI is far from over, the need for rigorous analysis has never been greater. This book thus brings together contributors from different fields and backgrounds to explore how the law might provide answers to some of the most pressing questions raised by AI. An outcome of the Católica Research Centre for the Future of Law and its interdisciplinary working group on Law and Artificial Intelligence, it includes contributions by leading scholars in the fields of technology, ethics and the law.info:eu-repo/semantics/publishedVersio

Interactions Between Activation And Repolarisation In Predisposition Towards Cardiac Arrhythmia

The lethal cardiac arrhythmias ventricular fibrillation (VF) and ventricular tachycardia (VT) are a leading cause of death in heart disease. We hypothesised that dynamic activation and repolarisation interactions will vary according to autonomic tone and the nature of the myocardial substrate as affected by disease states. This hypothesis was tested in a series of human and murine experiments. Incorporation of data from human electrophysiological studies into a linear computer model was able to predict activation dynamics of sequential extrastimuli. This served as a validation of the concept of dynamic interactions between activation and repolarisation in man. A human model of mental stress demonstrated that activation and repolarisation dynamics are altered by intrinsic autonomic stimulation. Specifically, a reduction in activation potential duration and an increase in dispersion of repolarisation occurred at short coupling intervals during stress. A weak increase in conduction velocity and excitability was also observed. Patients with early-stage arrhythmogenic right ventricular cardiomyopathy (ARVC) were seen to exhibit conduction changes prior to the onset of structural disease. This was used to determine potential diagnostic criteria based on surface ECG correlates of intracardiac observations. These criteria are able to distinguish early ARVC from benign right ventricular outflow tract tachycardia. Finally, the mechanism of modulation of tissue level activation dynamics were further studied using a novel thin-tissue slice murine model. Conduction velocity and excitability were modulated by both sympathetic and parasympathetic stimuli, parasympathetic modulation is demonstrated to be dependent on the Gαi2 regulatory pathway at the tissue level. The tissue slice method provides a novel tissue-level platform for the study of cardiac electrophysiology in genetically modified mice. In conclusion, this work demonstrates that modulations of activation and repolarisation dynamics are seen in pro-arrhythmic states, specifically in sympathetically active states and in arrhythmogenic right ventricular cardiomyopathy

XXIV congreso anual de la sociedad española de ingeniería biomédica (CASEIB2016)

En la presente edición, más de 150 trabajos de alto nivel científico van a ser presentados en 18 sesiones paralelas y 3 sesiones de póster, que se centrarán en áreas relevantes de la Ingeniería Biomédica. Entre las sesiones paralelas se pueden destacar la sesión plenaria Premio José María Ferrero Corral y la sesión de Competición de alumnos de Grado en Ingeniería Biomédica, con la participación de 16 alumnos de los Grados en Ingeniería Biomédica a nivel nacional. El programa científico se complementa con dos ponencias invitadas de científicos reconocidos internacionalmente, dos mesas redondas con una importante participación de sociedades científicas médicas y de profesionales de la industria de tecnología médica, y dos actos sociales que permitirán a los participantes acercarse a la historia y cultura valenciana. Por primera vez, en colaboración con FENIN, seJane Campos, R. (2017). XXIV congreso anual de la sociedad española de ingeniería biomédica (CASEIB2016). Editorial Universitat Politècnica de València. http://hdl.handle.net/10251/79277EDITORIA