Multiscale motion mapping -: A novel computer vision technique for quantitative, objective echocardiographic motion measurement independent of Doppler first clinical description and validation

Background-Objective, quantitative, segmental noninvasive/bedside measurement of cardiac motion is highly desirable in cardiovascular medicine, but current technology suffers from significant drawbacks, such as subjectivity of conventional echocardiographic reading, angle dependence of tissue Doppler measurements, radiation exposure by computer tomography, and infrastructure requirements in MRI. We hypothesized that computer vision technology could represent a powerful new paradigm for quantification in echocardiography. Methods and Results-We present multiscale motion mapping, a novel computer vision technology that is based on mathematical image processing and that exploits echocardiographic information in a fashion similar to the human visual system. It allows Doppler- and border-independent determination of motion and deformation in echocardiograms at arbitrary locations. Correctness of the measurements was documented in synthetic echocardiograms and phantom experiments. Exploratory case studies demonstrated its usefulness in a series of complex motion analyses that included abnormal septal motion and analysis of myocardial twisting. Clinical applicability was shown in a consecutive series of echocardiograms, in which good feasibility, good correlation with expert rating, and good intraobserver and interobserver concordance were documented. Separate assessment of 2D displacement and deformation at the same location was successfully applied to elucidate paradoxical septal motion, a common clinical problem. Conclusions-This is the first clinical report of multiscale motion mapping, a novel approach to echocardiographic motion quantification. For the first time, full 2D echocardiographic assessment of both motion and deformation is shown to be feasible. Overcoming current limitations, this computer vision-based technique opens a new door to objective analysis of complex heart motion.