SSL-DA: Semi-and Self-Supervised Learning with Dual Attention for Echocardiogram Segmentation.

Echocardiogram analysis plays a crucial role in assessing and diagnosing cardiac function, providing essential data to support medical diagnoses of heart disease. A key task, accurately identifying and segmenting the left ventricle (LV) in echocardiograms, remains challenging and labor-intensive. Current automated cardiac segmentation methods often lack the necessary accuracy and reproducibility, while semi-automated or manual annotations are excessively time-consuming. To address these limitations, we propose a novel segmentation framework, semi-and self-supervised learning with dual attention (SSL-DA) for echocardiogram segmentation. We start with a temporal masking network for pre-training. This network captures valuable information, such as echocardiogram periodicity. It also provides optimized initialization parameters for LV segmentation. We then employ a semi-supervised network to automatically segment the left ventricle, enhancing the model's learning with channel and spatial attention mechanisms to capture global channel dependencies and spatial dependencies across annotations. We evaluated SSL-DA on the publicly available EchoNet-Dynamic dataset, achieving a Dice similarity coefficient of 93.34% (95% CI, 93.23-93.46%), outperforming most prior CNN-based models. To further assess the generalization ability of SSL-DA, we conducted ablation experiments on the CAMUS dataset. Experimental results confirm that SSL-DA can quickly and accurately segment the left ventricle in echocardiograms, showing its potential for robust clinical application.