AI in the Echo Lab - Interview with Kristen Billick

Emmanuel Soto: AI is a trending topic in echocardiography, it's all the rage right now. And it was something of particular discussion at this year's meeting of the American Society of Echocardiography .??

Roberto Lang, the director of cardiovascular imaging at the 美国芝加哥大学 and a past president of the ASE, said that “echo labs that do not have AI will fall way behind.” . . . he believes that it's something that's going to transform echo dramatically in the future.??

So that leads me into my first question for you, which is have you integrated AI into your echo lab operations and if so, what are some ways you've done it and what's been the impact???

Kristen Billick: Right now, we are starting to use the auto measurements that we have on ultrasound machine equipment and so the sonographers are encouraged to use those. They still have a little improvement that needs to go along with that.??

The sonographer is still very much needed to confirm the measurements and make edits as [necessary]. We're also doing a lot of strain in our echo lab and the strain software automatically labels the four, two, and three chamber views to perform those measurements.?

So, we're definitely starting to use AI in our lab when it comes to, like, those tedious measurements that sonographers make. Hopefully that’s going to help with efficiency [and] make our studies go faster.??

We really just want to be more standardized. One thing with echo is that it can be very subjective.?

I might see something differently than you do, and we definitely all use the ASE guidelines, but again, [it’s] just our eyes might see things a little bit differently or measure in a little bit of a different place. And so, with AI, I'm hoping to see more standardization of measurements as well.??

I’m also hoping to see more in the field of interpretation of the echo. Ideally, it will take these measurements for us, we'll confirm them. But our sonographers spend quite a bit of time on preliminary reporting as well to prepare the report for the physician.??

Eventually, if software can get to where it's doing that piece for us and doing interpretations for us and then again we're going in and validating that interpretation or the physician is validating that, I think that's going to also be very helpful.?

Emmanuel Soto: ... it's not something that's going to replace the sonographer, but rather that maybe if anything will free up more time for other things and that allows for better findings.?

Through machine learning and deep learning, we have companies that are already creating AI models that are trained on these data sets and that really could speed up the process.?

But like we said, the landscape is changing a lot and you have a lot of sonographers on your team. So, given how quickly technology advances, how do you ensure that your team is up to date on the new techniques, on the new technologies???

Especially when you have sonographers who maybe been doing it for a while and they're used to the way they've been doing it, then you have new ones... I mean, do you automatically bring them into this AI culture or how is it that you've been doing that with the people you have now??

Kristen Billick: So, right now, our main site is really struggling in that like most echo labs we've been so short staffed, so as soon as the new grads graduate we're getting them in.??

Most of my satellite sites have my more senior sonographers, but my main lab has a lot of sonographers with less than five years of experience, the majority of them [actually]. And so that's been a struggle to make sure that quality and education is kept up with these [newer sonographers], and there's so many, like, you know, I have over 50 sonographers.?

We are lucky that we do have an [ultrasound] educator. We have extra resources for our lab, which I understand that not all labs can have. . . [our educator] does all the accreditation, teaching of new technologies…?

We're going to start using the dynamic heart model on Phillips which is also an AI feature. So [we’ll be] doing 3D left ventricular ejection fractions with dynamic heart model on all our patients as part of our standard protocol. So right now, we're just doing a lot of education and we're also reaching out to the vendor for support in [that process].?

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We hope you enjoyed this excerpt of our interview with Kristen Billick, BS, ACS, RCS, RDCS (AE, PE), FASE . Click here to watch the full video interview.