2023
Authors
Silva, A; Teixeira, R; Fontes Carvalho, R; Coimbra, M; Renna, F;
Publication
2023 45TH ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE & BIOLOGY SOCIETY, EMBC
Abstract
In this paper we study the heart sound segmentation problem using Deep Neural Networks. The impact of available electrocardiogram (ECG) signals in addition to phonocardiogram (PCG) signals is evaluated. To incorporate ECG, two different models considered, which are built upon a 1D U-net - an early fusion one that fuses ECG in an early processing stage, and a late fusion one that averages the probabilities obtained by two networks applied independently on PCG and ECG data. Results show that, in contrast with traditional uses of ECG for PCG gating, early fusion of PCG and ECG information can provide more robust heart sound segmentation. As a proof of concept, we use the publicly available PhysioNet dataset. Validation results provide, on average, a sensitivity of 97.2%, 94.5%, and 95.6% and a Positive Predictive Value of 97.5%, 96.2%, and 96.1% for Early-fusion, Late-fusion, and unimodal (PCG only) models, respectively, showing the advantages of combining both signals at early stages to segment heart sounds.
2023
Authors
Domingues, R; Nunes, F; Mancio, J; Fontes Carvalho, R; Coimbra, M; Pedrosa, J; Renna, F;
Publication
2023 45TH ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE & BIOLOGY SOCIETY, EMBC
Abstract
The use of contrast-enhanced computed tomography (CTCA) for detection of coronary artery disease (CAD) exposes patients to the risks of iodine contrast-agents and excessive radiation, increases scanning time and healthcare costs. Deep learning generative models have the potential to artificially create a pseudo-enhanced image from non-contrast computed tomography (CT) scans. In this work, two specific models of generative adversarial networks (GANs) - the Pix2Pix-GAN and the Cycle-GAN - were tested with paired non-contrasted CT and CTCA scans from a private and public dataset. Furthermore, an exploratory analysis of the trade-off of using 2D and 3D inputs and architectures was performed. Using only the Structural Similarity Index Measure (SSIM) and the Peak Signal-to-Noise Ratio (PSNR), it could be concluded that the Pix2Pix-GAN using 2D data reached better results with 0.492 SSIM and 16.375 dB PSNR. However, visual analysis of the output shows significant blur in the generated images, which is not the case for the Cycle-GAN models. This behavior can be captured by the evaluation of the Fr ' echet Inception Distance (FID), that represents a fundamental performance metric that is usually not considered by related works in the literature.
2024
Authors
Renna, F; Gaudio, A; Mattos, S; Plumbley, MD; Coimbra, MT;
Publication
IEEE ACCESS
Abstract
An algorithm for blind source separation (BSS) of the second heart sound (S2) into aortic and pulmonary components is proposed. It recovers aortic (A2) and pulmonary (P2) waveforms, as well as their relative delays, by solving an alternating optimization problem on the set of S2 sounds, without the use of auxiliary ECG or respiration phase measurement data. This unsupervised and data-driven approach assumes that the A2 and P2 components maintain the same waveform across heartbeats and that the relative delay between onset of the components varies according to respiration phase. The proposed approach is applied to synthetic heart sounds and to real-world heart sounds from 43 patients. It improves over two state-of-the-art BSS approaches by 10% normalized root mean-squared error in the reconstruction of aortic and pulmonary components using synthetic heart sounds, demonstrates robustness to noise, and recovery of splitting delays. The detection of pulmonary hypertension (PH) in a Brazilian population is demonstrated by training a classifier on three scalar features from the recovered A2 and P2 waveforms, and this yields an auROC of 0.76.
2024
Authors
Ferreira V.R.S.; de Paiva A.C.; Silva A.C.; de Almeida J.D.S.; Junior G.B.; Renna F.;
Publication
International Conference on Enterprise Information Systems, ICEIS - Proceedings
Abstract
This work proposes the use of a deep learning-based adversarial diffusion model to address the translation of contrast-enhanced from non-contrast-enhanced computed tomography (CT) images of the heart. The study overcomes challenges in medical image translation by combining concepts from generative adversarial networks (GANs) and diffusion models. Results were evaluated using the Peak signal to noise ratio (PSNR) and structural index similarity (SSIM) to demonstrate the model's effectiveness in generating contrast images while preserving quality and visual similarity. Despite successes, Root Mean Square Error (RMSE) analysis indicates persistent challenges, highlighting the need for continuous improvements. The intersection of GANs and diffusion models promises future advancements, significantly contributing to clinical practice. The table compares CyTran, CycleGAN, and Pix2Pix networks with the proposed model, indicating directions for improvement.
2024
Authors
Santos, R; Baeza, R; Filipe, VM; Renna, F; Paredes, H; Pedrosa, J;
Publication
2024 IEEE 22ND MEDITERRANEAN ELECTROTECHNICAL CONFERENCE, MELECON 2024
Abstract
Coronary artery calcium is a good indicator of coronary artery disease and can be used for cardiovascular risk stratification. Over the years, different deep learning approaches have been proposed to automatically segment coronary calcifications in computed tomography scans and measure their extent through calcium scores. However, most methodologies have focused on using 2D architectures which neglect most of the information present in those scans. In this work, we use a 3D convolutional neural network capable of leveraging the 3D nature of computed tomography scans and including more context in the segmentation process. In addition, the selected network is lightweight, which means that we can have 3D convolutions while having low memory requirements. Our results show that the predictions of the model, trained on the COCA dataset, are close to the ground truth for the majority of the patients in the test set obtaining a Dice score of 0.90 +/- 0.16 and a Cohen's linearly weighted kappa of 0.88 in Agatston score risk categorization. In conclusion, our approach shows promise in the tasks of segmenting coronary artery calcifications and predicting calcium scores with the objectives of optimizing clinical workflow and performing cardiovascular risk stratification.
2023
Authors
Reyna, A; Kiarashi, Y; Elola, A; Oliveira, J; Renna, F; Gu, A; Perez Alday, A; Sadr, N; Sharma, A; Kpodonu, J; Mattos, S; Coimbra, T; Sameni, R; Rad, AB; Clifford, D;
Publication
PLOS Digital Health
Abstract
Cardiac auscultation is an accessible diagnostic screening tool that can help to identify patients with heart murmurs, who may need follow-up diagnostic screening and treatment for abnormal cardiac function. However, experts are needed to interpret the heart sounds, limiting the accessibility of cardiac auscultation in resource-constrained environments. Therefore, the George B. Moody PhysioNet Challenge 2022 invited teams to develop algorithmic approaches for detecting heart murmurs and abnormal cardiac function from phonocardiogram (PCG) recordings of heart sounds. For the Challenge, we sourced 5272 PCG recordings from 1452 primarily pediatric patients in rural Brazil, and we invited teams to implement diagnostic screening algorithms for detecting heart murmurs and abnormal cardiac function from the recordings. We required the participants to submit the complete training and inference code for their algorithms, improving the transparency, reproducibility, and utility of their work. We also devised an evaluation metric that considered the costs of screening, diagnosis, misdiagnosis, and treatment, allowing us to investigate the benefits of algorithmic diagnostic screening and facilitate the development of more clinically relevant algorithms. We received 779 algorithms from 87 teams during the Challenge, resulting in 53 working codebases for detecting heart murmurs and abnormal cardiac function from PCG recordings. These algorithms represent a diversity of approaches from both academia and industry, including methods that use more traditional machine learning techniques with engineered clinical and statistical features as well as methods that rely primarily on deep learning models to discover informative features. The use of heart sound recordings for identifying heart murmurs and abnormal cardiac function allowed us to explore the potential of algorithmic approaches for providing more accessible diagnostic screening in resourceconstrained environments. The submission of working, open-source algorithms and the use of novel evaluation metrics supported the reproducibility, generalizability, and clinical relevance of the research from the Challenge. © 2023 Reyna et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
The access to the final selection minute is only available to applicants.
Please check the confirmation e-mail of your application to obtain the access code.