ControlEchoSynth: Boosting Ejection Fraction Estimation Models via Controlled Video Diffusion

Synthetic data generation represents a significant advancement in boosting the performance of machine learning (ML) models, particularly in fields where data acquisition is challenging, such as echocardiography. The acquisition and labeling of echocardiograms (echo) for heart assessment, crucial in point-of-care ultrasound (POCUS) settings, often encounter limitations due to the restricted number of echo views available, typically captured by operators with varying levels of experience. This study proposes a novel approach for enhancing clinical diagnosis accuracy by synthetically generating echo views. These views are conditioned on existing, real views of the heart, focusing specifically on the estimation of ejection fraction (EF), a critical parameter traditionally measured from biplane apical views. By integrating a conditional generative model, we demonstrate an improvement in EF estimation accuracy, providing a comparative analysis with traditional methods. Preliminary results indicate that our synthetic echoes, when used to augment existing datasets, not only enhance EF estimation but also show potential in advancing the development of more robust, accurate, and clinically relevant ML models. This approach is anticipated to catalyze further research in synthetic data applications, paving the way for innovative solutions in medical imaging diagnostics.

ProtoASNet: Dynamic Prototypes for Inherently Interpretable and Uncertainty-Aware Aortic Stenosis Classification in Echocardiography

Aortic stenosis (AS) is a common heart valve disease that requires accurate and timely diagnosis for appropriate treatment. Most current automatic AS severity detection methods rely on black-box models with a low level of trustworthiness, which hinders clinical adoption. To address this issue, we propose ProtoASNet, a prototypical network that directly detects AS from B-mode echocardiography videos, while making interpretable predictions based on the similarity between the input and learned spatio-temporal prototypes. This approach provides supporting evidence that is clinically relevant, as the prototypes typically highlight markers such as calcification and restricted movement of aortic valve leaflets. Moreover, ProtoASNet utilizes abstention loss to estimate aleatoric uncertainty by defining a set of prototypes that capture ambiguity and insufficient information in the observed data. This provides a reliable system that can detect and explain when it may fail. We evaluate ProtoASNet on a private dataset and the publicly available TMED-2 dataset, where it outperforms existing state-of-the-art methods with an accuracy of 80.0% and 79.7%, respectively. Furthermore, ProtoASNet provides interpretability and an uncertainty measure for each prediction, which can improve transparency and facilitate the interactive usage of deep networks to aid clinical decision-making. Our source code is available at: https://github.com/hooman007/ProtoASNet.