Regional Image Quality Scoring for 2-D Echocardiography Using Deep Learning

OBJECTIVE: To develop and compare methods to automatically estimate regional ultrasound image quality for echocardiography separate from view correctness. METHODS: Three methods for estimating image quality were developed: (i) classic pixel-based metric: the generalized contrast-to-noise ratio (gCNR), computed on myocardial segments (region of interest) and left ventricle lumen (background), extracted by a U-Net segmentation model; (ii) local image coherence: the average local coherence as predicted by a U-Net model that predicts image coherence from B-mode ultrasound images at the pixel level; (iii) deep convolutional network: an end-to-end deep-learning model that predicts the quality of each region in the image directly. These methods were evaluated against manual regional quality annotations provided by three experienced cardiologists. RESULTS: The results indicated poor performance of the gCNR metric, with Spearman correlation to annotations of ρ = 0.24. The end-to-end learning model obtained the best result, ρ = 0.69, comparable to the inter-observer correlation, ρ = 0.63. Finally, the coherence-based method, with ρ = 0.58, out-performed the classical metrics and was more generic than the end-to-end approach. CONCLUSION: The deep convolutional network provided the most accurate regional quality prediction, while the coherence-based method offered a more generalizable solution. gCNR showed limited effectiveness in this study. The image quality prediction tool is available as an open-source Python library at https://github.com/GillesVanDeVyver/arqee.