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Bello GA, Dawes TJ, Duan J, Biffi C, de Marvao A, Howard LSGE, Gibbs JSR, Wilkins MR, Cook SA, Rueckert D, O’Regan DP. Deep learning cardiac motion analysis for human survival prediction. NAT MACH INTELL 2019; 1:95-104. [PMID: 30801055 PMCID: PMC6382062 DOI: 10.1038/s42256-019-0019-2] [Citation(s) in RCA: 123] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 01/09/2019] [Indexed: 01/09/2023]
Abstract
Motion analysis is used in computer vision to understand the behaviour of moving objects in sequences of images. Optimising the interpretation of dynamic biological systems requires accurate and precise motion tracking as well as efficient representations of high-dimensional motion trajectories so that these can be used for prediction tasks. Here we use image sequences of the heart, acquired using cardiac magnetic resonance imaging, to create time-resolved three-dimensional segmentations using a fully convolutional network trained on anatomical shape priors. This dense motion model formed the input to a supervised denoising autoencoder (4Dsurvival), which is a hybrid network consisting of an autoencoder that learns a task-specific latent code representation trained on observed outcome data, yielding a latent representation optimised for survival prediction. To handle right-censored survival outcomes, our network used a Cox partial likelihood loss function. In a study of 302 patients the predictive accuracy (quantified by Harrell's C-index) was significantly higher (p = .0012) for our model C=0.75 (95% CI: 0.70 - 0.79) than the human benchmark of C=0.59 (95% CI: 0.53 - 0.65). This work demonstrates how a complex computer vision task using high-dimensional medical image data can efficiently predict human survival.
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Affiliation(s)
- Ghalib A. Bello
- MRC London Institute of Medical Sciences, Imperial College London,UK
| | - Timothy J.W. Dawes
- MRC London Institute of Medical Sciences, Imperial College London,UK
- National Heart and Lung Institute, Imperial College London, UK
| | - Jinming Duan
- MRC London Institute of Medical Sciences, Imperial College London,UK
- Department of Computing, Imperial College London, UK
| | - Carlo Biffi
- MRC London Institute of Medical Sciences, Imperial College London,UK
- Department of Computing, Imperial College London, UK
| | - Antonio de Marvao
- MRC London Institute of Medical Sciences, Imperial College London,UK
| | | | - J. Simon R. Gibbs
- National Heart and Lung Institute, Imperial College London, UK
- Imperial College Healthcare NHS Trust, London, UK
| | - Martin R. Wilkins
- Division of Experimental Medicine, Department of Medicine, Imperial College London, UK
| | - Stuart A. Cook
- MRC London Institute of Medical Sciences, Imperial College London,UK
- National Heart and Lung Institute, Imperial College London, UK
- National Heart Centre Singapore, Singapore, and Duke-NUS Graduate Medical School, Singapore
| | | | - Declan P. O’Regan
- MRC London Institute of Medical Sciences, Imperial College London,UK
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