Optimizing Input Selection for Cardiac Model Training and Inference: An Efficient 3D Convolutional Neural Networks-Based Approach to Automate Coronary Angiogram Video Selection

Objective: To develop an efficient and automated method for selecting appropriate coronary angiography videos for training deep learning models, thereby improving the accuracy and efficiency of medical image analysis. Patients and Methods: We developed deep learning models using 232 coronary angiographic studies from the Mayo Clinic. We utilized 2 state-of-the-art convolutional neural networks (CNN: ResNet and X3D) to identify low-quality angiograms through binary classification (satisfactory/unsatisfactory). Ground truth for the quality of the input angiogram was determined by 2 experienced cardiologists. We validated the developed model in an independent dataset of 3208 procedures from 3 Mayo sites. Results: The 3D-CNN models outperformed their 2D counterparts, with the X3D-L model achieving superior performance across all metrics (AUC 0.98, accuracy 0.96, precision 0.87, and F1 score 0.92). Compared with 3D models, 2D architectures are smaller and less computationally complex. Despite having a 3D architecture, the X3D-L model had lower computational demand (19.34 Giga Multiply Accumulate Operation) and parameter count (5.34 M) than 2D models. When validating models on the independent dataset, slight decreases in all metrics were observed, but AUC and accuracy remained robust (0.95 and 0.92, respectively, for the X3D-L model). Conclusion: We developed a rapid and effective method for automating the selection of coronary angiogram video clips using 3D-CNNs, potentially improving model accuracy and efficiency in clinical applications. The X3D-L model reports a balanced trade-off between computational efficiency and complexity, making it suitable for real-life clinical applications.