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Deep learning-based automatic left atrial appendage filling defects assessment on cardiac computed tomography for clinical and subclinical atrial fibrillation patients.


ABSTRACT:

Rationale and objectives

Selecting region of interest (ROI) for left atrial appendage (LAA) filling defects assessment can be time consuming and prone to subjectivity. This study aimed to develop and validate a novel artificial intelligence (AI), deep learning (DL) based framework for automatic filling defects assessment on CT images for clinical and subclinical atrial fibrillation (AF) patients.

Materials and methods

A total of 443,053 CT images were used for DL model development and testing. Images were analyzed by the AI framework and expert cardiologists/radiologists. The LAA segmentation performance was evaluated using Dice coefficient. The agreement between manual and automatic LAA ROI selections was evaluated using intraclass correlation coefficient (ICC) analysis. Receiver operating characteristic (ROC) curve analysis was used to assess filling defects based on the computed LAA to ascending aorta Hounsfield unit (HU) ratios.

Results

A total of 210 patients (Group 1: subclinical AF, n = 105; Group 2: clinical AF with stroke, n = 35; Group 3: AF for catheter ablation, n = 70) were enrolled. The LAA volume segmentation achieved 0.931-0.945 Dice scores. The LAA ROI selection demonstrated excellent agreement (ICC ≥0.895, p < 0.001) with manual selection on the test sets. The automatic framework achieved an excellent AUC score of 0.979 in filling defects assessment. The ROC-derived optimal HU ratio threshold for filling defects detection was 0.561.

Conclusion

The novel AI-based framework could accurately segment the LAA region and select ROIs while effectively avoiding trabeculae for filling defects assessment, achieving close-to-expert performance. This technique may help preemptively detect the potential thromboembolic risk for AF patients.

SUBMITTER: Chen L 

PROVIDER: S-EPMC9868534 | biostudies-literature | 2023 Jan

REPOSITORIES: biostudies-literature

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Publications

Deep learning-based automatic left atrial appendage filling defects assessment on cardiac computed tomography for clinical and subclinical atrial fibrillation patients.

Chen Ling L   Huang Sung-Hao SH   Wang Tzu-Hsiang TH   Lan Tzuo-Yun TY   Tseng Vincent S VS   Tsao Hsuan-Ming HM   Wang Hsueh-Han HH   Tang Gau-Jun GJ  

Heliyon 20230113 1


<h4>Rationale and objectives</h4>Selecting region of interest (ROI) for left atrial appendage (LAA) filling defects assessment can be time consuming and prone to subjectivity. This study aimed to develop and validate a novel artificial intelligence (AI), deep learning (DL) based framework for automatic filling defects assessment on CT images for clinical and subclinical atrial fibrillation (AF) patients.<h4>Materials and methods</h4>A total of 443,053 CT images were used for DL model development  ...[more]

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