Infarct Localization From Myocardial Deformation: Prediction and Uncertainty Quantification by Regression From a Low-Dimensional Space

IEEE Trans Med Imaging. 2016 Oct;35(10):2340-2352. doi: 10.1109/TMI.2016.2562181. Epub 2016 May 3.

Abstract

Diagnosing and localizing myocardial infarct is crucial for early patient management and therapy planning. We propose a new method for predicting the location of myocardial infarct from local wall deformation, which has value for risk stratification from routine examinations such as (3D) echocardiography. The pipeline combines non-linear dimensionality reduction of deformation patterns and two multi-scale kernel regressions. Confidence in the diagnosis is assessed by a map of local uncertainties, which integrates plausible infarct locations generated from the space of reduced dimensionality. These concepts were tested on 500 synthetic cases generated from a realistic cardiac electromechanical model, and 108 pairs of 3D echocardiographic sequences and delayed-enhancement magnetic resonance images from real cases. Infarct prediction is made at a spatial resolution around 4 mm, more than 10 times smaller than the current diagnosis, made regionally. Our method is accurate, and significantly outperforms the clinically-used thresholding of the deformation patterns (on real data: sensitivity/specificity of 0.828/0.804, area under the curve: 0.909 versus 0.742 for the most predictive strain component). Uncertainty adds value to refine the diagnosis and eventually re-examine suspicious cases.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Algorithms
  • Databases, Factual
  • Heart / diagnostic imaging*
  • Heart / physiology
  • Humans
  • Image Interpretation, Computer-Assisted / methods*
  • Magnetic Resonance Imaging
  • Myocardial Infarction / diagnostic imaging*
  • ROC Curve
  • Regression Analysis