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      Artificial intelligence and cardiovascular imaging: A win–win combination

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          Abstract

          Rapid development of artificial intelligence (AI) is gaining grounds in medicine. Its huge impact and inevitable necessity are also reflected in cardiovascular imaging. Although AI would probably never replace doctors, it can significantly support and improve their productivity and diagnostic performance. Many algorithms have already proven useful at all stages of the cardiac imaging chain. Their crucial practical applications include classification, automatic quantification, notification, diagnosis, and risk prediction. Consequently, more reproducible and repeatable studies are obtained, and personalized reports may be available to any patient. Utilization of AI also increases patient safety and decreases healthcare costs. Furthermore, AI is particularly useful for beginners in the field of cardiac imaging as it provides anatomic guidance and interpretation of complex imaging results. In contrast, lack of interpretability and explainability in AI carries a risk of harmful recommendations. This review was aimed at summarizing AI principles, essential execution requirements, and challenges as well as its recent applications in cardiovascular imaging.

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          Most cited references58

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          Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging.

          The rapid technological developments of the past decade and the changes in echocardiographic practice brought about by these developments have resulted in the need for updated recommendations to the previously published guidelines for cardiac chamber quantification, which was the goal of the joint writing group assembled by the American Society of Echocardiography and the European Association of Cardiovascular Imaging. This document provides updated normal values for all four cardiac chambers, including three-dimensional echocardiography and myocardial deformation, when possible, on the basis of considerably larger numbers of normal subjects, compiled from multiple databases. In addition, this document attempts to eliminate several minor discrepancies that existed between previously published guidelines.
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            High-performance medicine: the convergence of human and artificial intelligence

            Eric Topol (2019)
            The use of artificial intelligence, and the deep-learning subtype in particular, has been enabled by the use of labeled big data, along with markedly enhanced computing power and cloud storage, across all sectors. In medicine, this is beginning to have an impact at three levels: for clinicians, predominantly via rapid, accurate image interpretation; for health systems, by improving workflow and the potential for reducing medical errors; and for patients, by enabling them to process their own data to promote health. The current limitations, including bias, privacy and security, and lack of transparency, along with the future directions of these applications will be discussed in this article. Over time, marked improvements in accuracy, productivity, and workflow will likely be actualized, but whether that will be used to improve the patient-doctor relationship or facilitate its erosion remains to be seen.
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              Deep Learning Techniques for Automatic MRI Cardiac Multi-structures Segmentation and Diagnosis: Is the Problem Solved?

              Delineation of the left ventricular cavity, myocardium, and right ventricle from cardiac magnetic resonance images (multi-slice 2-D cine MRI) is a common clinical task to establish diagnosis. The automation of the corresponding tasks has thus been the subject of intense research over the past decades. In this paper, we introduce the "Automatic Cardiac Diagnosis Challenge" dataset (ACDC), the largest publicly available and fully annotated dataset for the purpose of cardiac MRI (CMR) assessment. The dataset contains data from 150 multi-equipments CMRI recordings with reference measurements and classification from two medical experts. The overarching objective of this paper is to measure how far state-of-the-art deep learning methods can go at assessing CMRI, i.e., segmenting the myocardium and the two ventricles as well as classifying pathologies. In the wake of the 2017 MICCAI-ACDC challenge, we report results from deep learning methods provided by nine research groups for the segmentation task and four groups for the classification task. Results show that the best methods faithfully reproduce the expert analysis, leading to a mean value of 0.97 correlation score for the automatic extraction of clinical indices and an accuracy of 0.96 for automatic diagnosis. These results clearly open the door to highly accurate and fully automatic analysis of cardiac CMRI. We also identify scenarios for which deep learning methods are still failing. Both the dataset and detailed results are publicly available online, while the platform will remain open for new submissions.
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                Author and article information

                Journal
                Anatol J Cardiol
                Anatol J Cardiol
                Anatolian Journal of Cardiology
                Kare Publishing (Turkey )
                2149-2263
                2149-2271
                October 2020
                28 September 2020
                : 24
                : 4
                : 214-223
                Affiliations
                [1]Department of Medicine and Surgery, University of Milano-Bicocca; Milan- Italy
                [1 ]1 st Department of Cardiology, Poznan University of Medical Sciences; Poznan- Poland
                [2 ]Cardiovascular Imaging Unit, Department of Cardiovascular, Neural and Metabolic Sciences, Instituto Auxologico Italiano, IRCCS; Milan- Italy
                Author notes
                Address for correspondence: Luigi P. Badano, MD, PhD, Department of Medicine and Surgery, University of Milano-Bicocca; Milan- Italy Phone: +39 3756119209 E-mail: luigi.badano@ 123456unimib.it
                Article
                AJC-24-214
                10.14744/AnatolJCardiol.2020.94491
                7585956
                33001058
                fe212140-a43c-4eb8-9dee-ac3ea5f5b98b
                Copyright: © 2020 Turkish Society of Cardiology

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

                History
                : 03 September 2020
                Categories
                Review

                artificial intelligence,machine learning,deep learning,echocardiography,cardiac magnetic resonance,cardiac computed tomography,nuclear cardiac imaging

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