Figure 1.

Artificial intelligence data flow. EchoGo Core is an automated, cloud-based software medical device for processing of echocardiographic images. Echocardiographic images are uploaded to the cloud-based environment in DICOM format whereby an automated pipeline identifies the apical two and four chamber images available for analysis. Trained and accredited cardiac physiologists (operators) review the identified images and ensure image selection is appropriate. Apical images are then passed to convolutional neural networks which delineate the left ventricular endocardium, predict the position of endocardial segments using the 18-segment model and then contour the endocardial border. Operators conduct a quality control check of all contours produced by the software by either accepting or rejecting them. Operators are unable to manually edit or adjust contours but they are able to select available alternative images for auto-contouring. Left ventricular global longitudinal strain is calculated as the average Lagrangian strain from contours of the apical two and four chamber images. Left ventricular volumes and ejection fraction are calculated using the apical two and four chamber contours using the Simpson’s biplane method.