Purpose: Echocardiography is the most commonly used modality for assessing the heart in clinical practice. In an echocardiographic exam, an ultrasound probe samples the heart from different orientations and positions, thereby creating different viewpoints for assessing the cardiac function. The determination of the probe viewpoint forms an essential step in automatic echocardiographic image analysis.Approach: In this study, convolutional neural networks are used for the automated identification of 14 different anatomical echocardiographic views (larger than any previous study) in a dataset of 8,732 videos acquired from 374 patients. Differentiable architecture search approach was utilised to design small neural network architectures for rapid inference while maintaining high accuracy. The impact of the image quality and resolution, size of the training dataset, and number of echocardiographic view classes on the efficacy of the models were also investigated.Results: In contrast to the deeper classification architectures, the proposed models had significantly lower number of trainable parameters (up to 99.9% reduction), achieved comparable classification performance (accuracy 88.4-96.0%, precision 87.8-95.2%, recall 87.1-95.1%) and real-time performance with inference time per image of 3.6-12.6ms.Conclusion: Compared with the standard classification neural network architectures, the proposed models are faster and achieve comparable classification performance. They also require less training data. Such models can be used for real-time detection of the standard views.

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Oral squamous cell carcinoma (OSCC) is amongst the most common cancers, with more than 377,000 new cases worldwide each year. OSCC prognosis remains poor, related to cancer presentation at a late stage, indicating the need for early detection to improve patient prognosis. OSCC is often preceded by a premalignant state known as oral epithelial dysplasia (OED), which is diagnosed and graded using subjective histological criteria leading to variability and prognostic unreliability. In this work, we propose a deep learning approach for the development of prognostic models for malignant transformation and their association with clinical outcomes in histology whole slide images (WSIs) of OED tissue sections. We train a weakly supervised method on OED cases (n = 137) with malignant transformation (n = 50) and mean malignant transformation time of 6.51 years ( ± 5.35 SD). Stratified five-fold cross-validation achieved an average area under the receiver-operator characteristic curve (AUROC) of 0.78 for predicting malignant transformation in OED. Hotspot analysis revealed various features of nuclei in the epithelium and peri-epithelial tissue to be significant prognostic factors for malignant transformation, including the count of peri-epithelial lymphocytes (PELs) (p < 0.05), epithelial layer nuclei count (NC) (p < 0.05), and basal layer NC (p < 0.05). Progression-free survival (PFS) using the epithelial layer NC (p < 0.05, C-index = 0.73), basal layer NC (p < 0.05, C-index = 0.70), and PELs count (p < 0.05, C-index = 0.73) all showed association of these features with a high risk of malignant transformation in our univariate analysis. Our work shows the application of deep learning for the prognostication and prediction of PFS of OED for the first time and offers potential to aid patient management. Further evaluation and testing on multi-centre data is required for validation and translation to clinical practice.

Following the successful application of the U-Net to medical images, there have been different encoder-decoder models proposed as an improvement to the original U-Net for segmenting echocardiographic images. This study aims to examine the performance of the state-of-the-art proposed models claimed to have better accuracies, as well as the original U-Net model by applying them to an independent dataset of patients to segment the endocardium of the Left Ventricle in 2D automatically. The prediction outputs of the models are used to evaluate the performance of the models by comparing the automated results against the expert annotations (gold standard). Our results reveal that the original U-Net model outperforms other models by achieving an average Dice coefficient of 0.92±0.05, and Hausdorff distance of 3.97±0.82.