Ashley Akerman, Lori Bernard, Tine Deschamps, Bernadette Foster, Will Hawkes, Eila Mirhadi, Hania Piotrowska, Rizwan Sarwar, Louise Tetlow, Gary Woodward, Harald Becher.
Poster of the study. Click image to open in new window.
Background
- Transthoracic echocardiography ( assessment of the left ventricle ( is central in the early detection of cancer therapy related cardiac dysfunction CTRCD.
- Measurement variability ca be reduced by both contrast enhancement of TTEs, and automated contouring of the LV with artificial intelligence (AI).
Method
- Single centre retrospective study.
- Patients monitored for CRTCD at Mazankowski Alberta.
- Heart Institute ( Canada) TTE at onset of cancer therapy, and after at least 3 months of treatment.
- Manually contoured contrast enhanced images (MAN.CON) with IntelliSpace Cardiovascular (Phillips) compared to automated contouring on non contrast enhanced images (AUTO NON) using EchoGo Core ( UK).
- Differences and agreement between methods evaluated by i statistical equivalence (two one sided t tests),tests),(error between methods, via root mean squared error (RMSE Deming Regression), and ( average bias and associated 95 confidence interval (Bland Altman.
- Reproducibility estimates in a similar cohort informed equivalence bounds ( 20 mL ESV, 15 mL EF, 5 Thavendiranathen et al 2013 JACC and were used to interpret mean error and bias.
Results
- AUTO-NON differentiated functional cardiac differences between diagnoses, at baseline and during cancer therapy(Figure1).
- Most differences between MAN-CON and AUTO-NON were small enough tobe considered statistically equivalent (Table2 and Figure2).
- For all outcomes and diagnoses, mean bias (Bland-Altman) was also within acceptable limits(Table2).
Conclusion
Despite poorer image quality, Automated contouring of non-contrast enhanced TTE are comparable to manually contoured contrast enhanced images. AI contouring of non-contrast enhanced TTEs has the potential to improve detection and management of CTRCD.