Why the study?
Noninvasive estimation of right atrial pressure by inferior vena cava measurement has significant inter-rater variability due to differences in observer experience, creating a need for automated approaches.
Does an AI-based system accurately estimate right atrial pressure and IVC diameter compared to expert manual measurements in patients undergoing routine echocardiography?
Does an AI-based system accurately estimate right atrial pressure and IVC diameter compared to expert manual measurements in patients undergoing routine echocardiography?
A fully automated AI system accurately quantifies IVC diameter and collapsibility for RAP estimation, demonstrating excellent agreement with expert manual measurements.
AI automation of IVC analysis may reduce RAP estimation variability; leaves open clinical adoption pending validation.
Current noninvasive estimation of right atrial pressure (RAP) by inferior vena cava (IVC) measurement during echocardiography may have significant inter-rater variability due to different levels of observers' experience. Therefore, there is a need to develop new approaches to decrease the variability of IVC analysis and RAP estimation. This study aims to develop a fully automated artificial intelligence (AI)-based system for automated IVC analysis and RAP estimation. We presented a multi-stage AI system to identify the IVC view, select good quality images, delineate the IVC region and quantify its thickness, enabling temporal tracking of its diameter and collapsibility changes. The automated system was trained and tested on expert manual IVC and RAP reference measurements obtained from 255 patients during routine clinical workflow. The performance was evaluated using Pearson correlation and Bland-Altman analysis for IVC values, as well as macro accuracy and chi-square test for RAP values. Our results show an excellent agreement (r=0.96) between automatically computed versus manually measured IVC values, and Bland-Altman analysis showed a small bias of [Formula: see text]0.33 mm. Further, there is an excellent agreement ([Formula: see text]) between automatically estimated versus manually derived RAP values with a macro accuracy of 0.85. The proposed AI-based system accurately quantified IVC diameter, collapsibility index, both are used for RAP estimation. This automated system could serve as a paradigm to perform IVC analysis in routine echocardiography and support various cardiac diagnostic applications.
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Zamzmi et al. (2023) studied this question.
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