Yue Zhang

Abdoul Aziz Amadou, Yue Zhang, Sebastien Piat et al.

Quantitative evaluation of echocardiography is essential for precise assessment of cardiac condition, monitoring disease progression, and guiding treatment decisions. The diverse nature of echo images, including variations in probe types, manufacturers, and pathologies, poses challenges for developing artificial intelligent models that can generalize across different clinical practice. We introduce EchoApex, the first general-purpose vision foundation model echocardiography with applications on a variety of clinical practice. Leveraging self-supervised learning, EchoApex is pretrained on over 20 million echo images from 11 clinical centres. By incorporating task-specific decoders and adapter modules, we demonstrate the effectiveness of EchoApex on 4 different kind of clinical applications with 28 sub-tasks, including view classification, interactive structure segmentation, left ventricle hypertrophy detection and automated ejection fraction estimation from view sequences. Compared to state-of-the-art task-specific models, EchoApex attains improved performance with a unified image encoding architecture, demonstrating the benefits of model pretraining at scale with in-domain data. Furthermore, EchoApex illustrates the potential for developing a general-purpose vision foundation model tailored specifically for echocardiography, capable of addressing a diverse range of clinical applications with high efficiency and efficacy.

Yuheng Li, Yue Zhang, Abdoul Aziz Amadou et al.

Echocardiography is the most widely used imaging modality in cardiology, yet its interpretation remains labor-intensive and inherently multimodal, requiring view recognition, quantitative measurements, qualitative assessments, and guideline-based reasoning. While recent vision-language models (VLMs) have achieved broad success in natural images and certain medical domains, their potential in echocardiography has been limited by the lack of large-scale, clinically grounded image-text datasets and the absence of measurement-based reasoning central to echo interpretation. We introduce EchoGround-MIMIC, the first measurement-grounded multimodal echocardiography dataset, comprising 19,065 image-text pairs from 1,572 patients with standardized views, structured measurements, measurement-grounded captions, and guideline-derived disease labels. Building on this resource, we propose EchoVLM, a vision-language model that incorporates two novel pretraining objectives: (i) a view-informed contrastive loss that encodes the view-dependent structure of echocardiographic imaging, and (ii) a negation-aware contrastive loss that distinguishes clinically critical negative from positive findings. Across five types of clinical applications with 36 tasks spanning multimodal disease classification, image-text retrieval, view classification, chamber segmentation, and landmark detection, EchoVLM achieves state-of-the-art performance (86.5% AUC in zero-shot disease classification and 95.1% accuracy in view classification). We demonstrate that clinically grounded multimodal pretraining yields transferable visual representations and establish EchoVLM as a foundation model for end-to-end echocardiography interpretation. We will release EchoGround-MIMIC and the data curation code, enabling reproducibility and further research in multimodal echocardiography interpretation.