title: Computer-aided diagnosis via model-based shape analysis: automated classification of wall motion abnormalities in echocardiograms.
abstract: OBJECTIVE
  Shape analysis of endocardial contour sequences from echocardiograms can provide classification of wall motion abnormalities (WMA).
  
  
  METHODS
  We previously reported on active appearance motion models (AAMM) for automated detection of endocardial contours in sequences of echocardiograms. The shape analysis of AAMM renders eigenvariations of shape/motion, including typical normal and pathologic endocardial contraction patterns. A set of stress echocardiograms (single-beat four-chamber and two-chamber sequences with expert-verified endocardial contours) of 129 infarct patients was split randomly into training (n = 65) and testing (n = 64) sets. AAMMs were generated from the training set and AAMM shape coefficients (ASCs) were extracted for all sequences and statistically related to regional/global visual wall motion scoring (VWMS) and volumetric parameters.
  
  
  RESULTS
  Linear regression showed clear correlations between ASCs and VWMS. Discriminant analysis showed good prediction by ASCs of both segmental (74% correctness) and global WMA (90% correctness). Volumetric parameters correlated poorly to regional VWMS.
  
  
  CONCLUSIONS
  1) ASCs show promising accuracy for automated WMA classification. 2) VWMS and endocardial border motion are closely related; with accurate automated border detection, automated WMA classification should be feasible. 3) ASC shape analysis allows contour set evaluation by direct comparison to clinical parameters.
authors.affiliation: Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Johan G
authors.initials: JG
authors.lastname: Bosch
authors.forename: Francisca
authors.initials: F
authors.lastname: Nijland
authors.forename: Steven C
authors.initials: SC
authors.lastname: Mitchell
authors.forename: Boudewijn P F
authors.initials: BP
authors.lastname: Lelieveldt
authors.forename: Otto
authors.initials: O
authors.lastname: Kamp
authors.forename: Johan H C
authors.initials: JH
authors.lastname: Reiber
authors.forename: Milan
authors.initials: M
authors.lastname: Sonka
mesh_terms: D002306:Cardiac Volume / Q000502:physiology; D003936:Diagnosis, Computer-Assisted; D016002:Discriminant Analysis; D025401:Echocardiography, Stress; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D016014:Linear Models; D009200:Myocardial Contraction / Q000502:physiology*; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016571:Neural Networks, Computer; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology