title: Infarct Localization From Myocardial Deformation: Prediction and Uncertainty Quantification by Regression From a Low-Dimensional Space.
abstract: Diagnosing and localizing myocardial infarct is crucial for early patient management and therapy planning. We propose a new method for predicting the location of myocardial infarct from local wall deformation, which has value for risk stratification from routine examinations such as (3D) echocardiography. The pipeline combines non-linear dimensionality reduction of deformation patterns and two multi-scale kernel regressions. Confidence in the diagnosis is assessed by a map of local uncertainties, which integrates plausible infarct locations generated from the space of reduced dimensionality. These concepts were tested on 500 synthetic cases generated from a realistic cardiac electromechanical model, and 108 pairs of 3D echocardiographic sequences and delayed-enhancement magnetic resonance images from real cases. Infarct prediction is made at a spatial resolution around 4 mm, more than 10 times smaller than the current diagnosis, made regionally. Our method is accurate, and significantly outperforms the clinically-used thresholding of the deformation patterns (on real data: sensitivity/specificity of 0.828/0.804, area under the curve: 0.909 versus 0.742 for the most predictive strain component). Uncertainty adds value to refine the diagnosis and eventually re-examine suspicious cases.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Duchateau
authors.forename: Mathieu
authors.initials: M
authors.lastname: De Craene
authors.forename: Pascal
authors.initials: P
authors.lastname: Allain
authors.forename: Eric
authors.initials: E
authors.lastname: Saloux
authors.forename: Maxime
authors.initials: M
authors.lastname: Sermesant
mesh_terms: D000465:Algorithms; D016208:Databases, Factual; D006321:Heart / Q000000981:diagnostic imaging* / Q000502:physiology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging; D009203:Myocardial Infarction / Q000000981:diagnostic imaging*; D012372:ROC Curve; D012044:Regression Analysis