Optimizing Point-of-Care Ultrasound Video Acquisition for Probabilistic Multi-Task Heart Failure Detection

Purpose: Echocardiography with point-of-care ultrasound (POCUS) must support clinical decision-making under tight bedside time and operator-effort constraints. We introduce a personalized data acquisition strategy in which an RL agent, given a partially observed multi-view study, selects the next view to acquire or terminates acquisition to support heart-failure (HF) assessment. Upon termination, a diagnostic model jointly predicts aortic stenosis (AS) severity and left ventricular ejection fraction (LVEF), two key HF biomarkers, and outputs uncertainty, enabling an explicit trade-off between diagnostic performance and acquisition cost. Methods: We model POCUS as a sequential acquisition problem: at each step, a video selector (RL agent) chooses the next view to acquire or terminates acquisition. Upon termination, a shared multi-view transformer performs multi-task inference with two heads, ordinal AS classification, and LVEF regression, and outputs Gaussian predictive distributions yielding ordinal probabilities over AS classes and EF thresholds. These probabilities drive a reward that balances expected diagnostic benefit against acquisition cost, producing patient-specific acquisition pathways. Results: The dataset comprises 12,180 patient-level studies, split into training/validation/test sets (75/15/15). On the 1,820 test studies, our method matches full-study performance while using 32% fewer videos, achieving 77.2% mean balanced accuracy (bACC) across AS severity classification and LVEF estimation, demonstrating robust multi-task performance under acquisition budgets. Conclusion: Patient-tailored, cost-aware acquisition can streamline POCUS workflows while preserving decision quality, producing interpretable scan pathways suited to bedside use. The framework is extensible to additional cardiac endpoints and merits prospective evaluation for clinical integration.

Point Tracking as a Temporal Cue for Robust Myocardial Segmentation in Echocardiography Videos

Purpose: Myocardium segmentation in echocardiography videos is a challenging task due to low contrast, noise, and anatomical variability. Traditional deep learning models either process frames independently, ignoring temporal information, or rely on memory-based feature propagation, which accumulates error over time. Methods: We propose Point-Seg, a transformer-based segmentation framework that integrates point tracking as a temporal cue to ensure stable and consistent segmentation of myocardium across frames. Our method leverages a point-tracking module trained on a synthetic echocardiography dataset to track key anatomical landmarks across video sequences. These tracked trajectories provide an explicit motion-aware signal that guides segmentation, reducing drift and eliminating the need for memory-based feature accumulation. Additionally, we incorporate a temporal smoothing loss to further enhance temporal consistency across frames. Results: We evaluate our approach on both public and private echocardiography datasets. Experimental results demonstrate that Point-Seg has statistically similar accuracy in terms of Dice to state-of-the-art segmentation models in high quality echo data, while it achieves better segmentation accuracy in lower quality echo with improved temporal stability. Furthermore, Point-Seg has the key advantage of pixel-level myocardium motion information as opposed to other segmentation methods. Such information is essential in the computation of other downstream tasks such as myocardial strain measurement and regional wall motion abnormality detection. Conclusion: Point-Seg demonstrates that point tracking can serve as an effective temporal cue for consistent video segmentation, offering a reliable and generalizable approach for myocardium segmentation in echocardiography videos. The code is available at https://github.com/DeepRCL/PointSeg.