Assessment of Transcatheter or Surgical Closure of Atrial Septal Defect using Interpretable Deep Keypoint Stadiometry

作者：Jing Wang, Wanqing Xie, Mingmei Cheng, Qun Wu, Fangyun Wang, Pei Li, Bo Fan, Xin Zhang, Binbin Wang, Xiaofeng Liu · 发表于：Research · 年份：2022 · DOI：10.34133/2022/9790653 · 被引用次数：9 · 研究领域：Cardiovascular and Diving-Related Complications、Congenital Heart Disease Studies、Cardiac Valve Diseases and Treatments

Automated echocardiogram interpretation with artificial intelligence (AI) has the potential to facilitate the serial diagnosis of heart defects by primary clinician. However, the fully automated and interpretable analysis pipeline for suggesting a treatment plan is largely underexplored. The present study targets to build an automatic and interpretable assistant for the transthoracic echocardiogram- (TTE-) based assessment of atrial septal defect (ASD) with deep learning (DL). We developed a novel deep keypoint stadiometry (DKS) model, which learns to precisely localize the keypoints, i.e., the endpoints of defects and followed by the absolute distance measurement with the scale. The closure plan and the size of the ASD occluder for transcatheter closure are derived based on the explicit clinical decision rules. A total of 3,474 2D and Doppler TTE from 579 patients were retrospectively collected from two clinical groups. The accuracy of closure classification using DKS ( 0.9425 ± 0.0052 ) outperforms the “black-box” model ( 0.7646 ± 0.0068 ; p < 0.0001 ) for within-center evaluation. The results in cross-center cases or using the quadratic weighted kappa as an evaluation metric are consistent. The fine-grained keypoint label provides more explicit supervision for network training. While DKS can be fully automated, clinicians can intervene and edit at different steps of the process as well. Our deep learning keypoint localization can provide an...