Qing Cao

Aofan Jiang, Chaoqin Huang, Qing Cao et al.

Current computer-aided ECG diagnostic systems struggle with the underdetection of rare but critical cardiac anomalies due to the imbalanced nature of ECG datasets. This study introduces a novel approach using self-supervised anomaly detection pretraining to address this limitation. The anomaly detection model is specifically designed to detect and localize subtle deviations from normal cardiac patterns, capturing the nuanced details essential for accurate ECG interpretation. Validated on an extensive dataset of over one million ECG records from clinical practice, characterized by a long-tail distribution across 116 distinct categories, the anomaly detection-pretrained ECG diagnostic model has demonstrated a significant improvement in overall accuracy. Notably, our approach yielded a 94.7% AUROC, 92.2% sensitivity, and 92.5\% specificity for rare ECG types, significantly outperforming traditional methods and narrowing the performance gap with common ECG types. The integration of anomaly detection pretraining into ECG analysis represents a substantial contribution to the field, addressing the long-standing challenge of long-tail data distributions in clinical diagnostics. Furthermore, prospective validation in real-world clinical settings revealed that our AI-driven approach enhances diagnostic efficiency, precision, and completeness by 32%, 6.7%, and 11.8% respectively, when compared to standard practices. This advancement marks a pivotal step forward in the integration of AI within clinical cardiology, with particularly profound implications for emergency care, where rapid and accurate ECG interpretation is crucial. The contributions of this study not only push the boundaries of current ECG diagnostic capabilities but also lay the groundwork for more reliable and accessible cardiovascular care.

Durgesh Kumar Singh, Qing Cao, Sarina Thomas et al.

Clinical guidelines recommend performing left ventricular (LV) linear measurements in B-mode echocardiographic images at the basal level -- typically at the mitral valve leaflet tips -- and aligned perpendicular to the LV long axis along a virtual scanline (SL). However, most automated methods estimate landmarks directly from B-mode images for the measurement task, where even small shifts in predicted points along the LV walls can lead to significant measurement errors, reducing their clinical reliability. A recent semi-automatic method, EnLVAM, addresses this limitation by constraining landmark prediction to a clinician-defined SL and training on generated Anatomical Motion Mode (AMM) images to predict LV landmarks along the same. To enable full automation, a contour-aware SL placement approach is proposed in this work, in which the LV contour is estimated using a weakly supervised B-mode landmark detector. SL placement is then performed by inferring the LV long axis and the basal level- mimicking clinical guidelines. Building on this foundation, we introduce \textit{WiseLVAM} -- a novel, fully automated yet manually adaptable framework for automatically placing the SL and then automatically performing the LV linear measurements in the AMM mode. \textit{WiseLVAM} utilizes the structure-awareness from B-mode images and the motion-awareness from AMM mode to enhance robustness and accuracy with the potential to provide a practical solution for the routine clinical application. The source code is publicly available at https://github.com/SFI-Visual-Intelligence/wiselvam.git.

Aofan Jiang, Chaoqin Huang, Qing Cao et al.

The electrocardiogram (ECG) is an essential tool for diagnosing heart disease, with computer-aided systems improving diagnostic accuracy and reducing healthcare costs. Despite advancements, existing systems often miss rare cardiac anomalies that could be precursors to serious, life-threatening issues or alterations in the cardiac macro/microstructure. We address this gap by focusing on self-supervised anomaly detection (AD), training exclusively on normal ECGs to recognize deviations indicating anomalies. We introduce a novel self-supervised learning framework for ECG AD, utilizing a vast dataset of normal ECGs to autonomously detect and localize cardiac anomalies. It proposes a novel masking and restoration technique alongside a multi-scale cross-attention module, enhancing the model's ability to integrate global and local signal features. The framework emphasizes accurate localization of anomalies within ECG signals, ensuring the method's clinical relevance and reliability. To reduce the impact of individual variability, the approach further incorporates crucial patient-specific information from ECG reports, such as age and gender, thus enabling accurate identification of a broad spectrum of cardiac anomalies, including rare ones. Utilizing an extensive dataset of 478,803 ECG graphic reports from real-world clinical practice, our method has demonstrated exceptional effectiveness in AD across all tested conditions, regardless of their frequency of occurrence, significantly outperforming existing models. It achieved superior performance metrics, including an AUROC of 91.2%, an F1 score of 83.7%, a sensitivity rate of 84.2%, a specificity of 83.0%, and a precision of 75.6% with a fixed recall rate of 90%. It has also demonstrated robust localization capabilities, with an AUROC of 76.5% and a Dice coefficient of 65.3% for anomaly localization.

Durgesh K. Singh, Ahcene Boubekki, Qing Cao et al.

Linear measurements of the left ventricle (LV) in the Parasternal Long Axis (PLAX) view using B-mode echocardiography are crucial for cardiac assessment. These involve placing 4-6 landmarks along a virtual scanline (SL) perpendicular to the LV axis near the mitral valve tips. Manual placement is time-consuming and error-prone, while existing deep learning methods often misalign landmarks, causing inaccurate measurements. We propose a novel framework that enhances LV measurement accuracy by enforcing straight-line constraints. A landmark detector is trained on Anatomical M-Mode (AMM) images, computed in real time from B-mode videos, then transformed back to B-mode space. This approach addresses misalignment and reduces measurement errors. Experiments show improved accuracy over standard B-mode methods, and the framework generalizes well across network architectures. Our semi-automatic design includes a human-in-the-loop step where the user only places the SL, simplifying interaction while preserving alignment flexibility and clinical relevance.