Image analysis of cardiac hepatopathy secondary to heart failure: Machine learning vs gastroenterologists and radiologists.

Background: Congestive hepatopathy, also known as nutmeg liver, is liver damage secondary to chronic heart failure (HF). Its morphological characteristics in terms of medical imaging are not defined and remain unclear.

Aim: To leverage machine learning to capture imaging features of congestive hepatopathy using incidentally acquired computed tomography (CT) scans.

Methods: We retrospectively analyzed 179 chronic HF patients who underwent echocardiography and CT within one year. Right HF severity was classified into three grades. Liver CT images at the paraumbilical vein level were used to develop a ResNet-based machine learning model to predict tricuspid regurgitation (TR) severity. Model accuracy was compared with that of six gastroenterology and four radiology experts.

Results: In the included patients, 120 were male (mean age: 73.1 ± 14.4 years). The accuracy of the results predicting TR severity from a single CT image for the machine learning model was significantly higher than the average accuracy of the experts. The model was found to be exceptionally reliable for predicting severe TR.

Conclusion: Deep learning models, particularly those using ResNet architectures, can help identify morphological changes associated with TR severity, aiding in early liver dysfunction detection in patients with HF, thereby improving outcomes.