Artificial Intelligence to derive aligned strain in cine CMR to detect patients with myocardial fibrosis: an open and scrutinizable approach

利用人工智能技术从电影式心脏磁共振成像中提取对齐应变,以检测心肌纤维化患者:一种开放且可审查的方法

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Abstract

Cine Cardiac Magnetic Resonance (CMR) is the gold standard for cardiac function evaluation, incorporating ejection fraction (EF) and strain as vital indicators of abnormal deformation. Rare pathologies like Duchenne muscular dystrophies (DMD) are monitored with repeated late gadolinium-enhanced (LGE) CMR for identification of myocardial fibrosis. However, it is judicious to reduce repeated gadolinium exposure and rather employ strain analysis from cine CMR. This solution is limited so far since full strain curves are not comparable between individual cardiac cycles and current practice mainly neglects diastolic deformation patterns. Our novel Deep Learning-based approach derives strain values aligned by key frames throughout the cardiac cycle. In a reproducibility scenario (57+82 patients), our results reveal five times more significant differences (22 vs. 4) between patients with scar and without, enhancing scar detection by +30%, improving detection of patients with preserved EF by +61%, with an overall sensitivity/specificity of 82/81%.

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