Automated Sonographic Detection of Pulmonary Embolism Using Machine Learning Algorithm

PROJECT SUMMARY/ABSTRACT
We propose a better way to diagnose pulmonary embolism (PE) early and save lives. More than 900,000 people in the
United States suffer from acute PE, and about 100,000 die each year. With 10% of such cases being fatal within the first
hour of the onset of symptoms, rapid diagnosis of PE is critical to direct appropriate therapy. Unfortunately, clinical
evaluation alone is unreliable and often results in grave diagnostic delays. Furthermore, while echocardiography at the
patient’s bedside can rapidly detect heart dysfunction caused by PE, traditional echocardiography performed by
cardiology services is not readily available in acute care settings. Thus, there is a critical need for use of a rapid, non-
invasive diagnostic tool at the point-of-care (POC) to accurately assess for PE and direct emergency therapy. The focus of
this research is to develop innovative artificial intelligence algorithms that can transform the care of patients with PE by
enabling non-experts to use echocardiography to detect PE, direct emergency therapy, and improve survival. The
rationale underlying this proposal is that the proposed artificial intelligence technology tools will provide a relatively
simple and time-efficient strategy that can be implemented in most healthcare settings. This will, in turn, fulfill the overall
goal of creating a positive shift in the management of patients presenting with PE. The proposed specialized artificial
intelligence technology would ultimately be applicable to early detection of a wide variety of diseases. The long-term
goal of our research is to develop and implement effective automated ultrasound tools that would significantly impact the
diagnosis and treatment of different life-threatening conditions. The objective of this proposal is to develop and validate a
prototype mobile artificial intelligence enabled-software platform that can accurately detect echocardiographic signs of
PE. The hypothesis is that artificial intelligence algorithms will achieve levels of diagnostic accuracy equivalent to expert
physician sonographers in detecting PE. This hypothesis will be tested by pursuing two specific aims: 1) Develop a
machine learning algorithm for the detection of PE that can be extended to detect other cardiopulmonary conditions using
explicit echocardiographic signs of PE and implicit image content representations. 2) Validate the accuracy of the
machine learning algorithm to detect PE on echocardiographic images using explicit sonographic signs. Innovative
reinforcement learning techniques will be utilized to accomplish the specific aims. The proposed research is significant
because it will transform the care of patients with PE by enabling non-experts to use POC echocardiography. It will also
have an immediate, positive impact because it will help lower morbidity, mortality, improve quality of life, and decrease
healthcare costs by expediting diagnosis and therapeutic interventions. The proximate expected outcome of this work is
improvement in the evaluation of patients with life-threatening PE by inexperienced healthcare providers, which will
result in more accurate and rapid identification of cases that require emergency treatment. Our proposal aligns with the
NIBIB’s overall mission to advance healthcare through innovative engineering and, more specifically, its emphasis on
development of transformative unsupervised and semi-supervised machine learning technologies to enhance analysis of
complex medical images and data for diagnosing and treating a wide range of diseases and health conditions.

Grant Number: 5R21EB030677-02
NIH Institute/Center: NIH
Principal Investigator: Srikar Adhikari