{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T07:42:21Z","timestamp":1792654941459,"version":"4.5.0"},"reference-count":41,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100003287","name":"Rally Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100003287","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100030574","name":"Catherine Holmes Wilkins Charitable Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100030574","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009992","name":"Seattle Children's Research Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009992","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23HL183696"],"award-info":[{"award-number":["K23HL183696"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01CA211996"],"award-info":[{"award-number":["R01CA211996"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R21CA277746"],"award-info":[{"award-number":["R21CA277746"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U10CA180886"],"award-info":[{"award-number":["U10CA180886"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UG1CA189955"],"award-info":[{"award-number":["UG1CA189955"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Cardiomyopathy (CM) is a leading cause of late mortality in childhood cancer survivors, but it is often identified only after irreversible cardiac remodeling has already occurred. In this proof\u2010of\u2010concept study, we assessed whether deep learning applied to routine echocardiographic videos can identify features predictive of future CM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed parasternal short\u2010axis clips from cancer survivors \u226421 years old at cancer diagnosis. 3D deep convolutional neural networks were trained to classify CM\u2010positive versus CM\u2010negative studies from echocardiograms conducted up to five years prior to CM diagnosis. The performance was assessed on internal hold\u2010out validation (Center 1) and external validation cohorts (Centers 2, 3). The model's prognostic value was evaluated by stratifying patients into high\u2010 and low\u2010risk groups for developing CM, and probability of future CM was assessed using cumulative incidence and proportional hazards regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The model achieved an area under the receiver operating characteristic curve (AUROC) of 0.87\u00b10.05 and an area under the precision\u2013recall curve (AUPRC) of 0.74\u00b10.07 on the internal hold\u2010out set. External validation showed near\u2010chance single\u2010study discrimination (AUROC 0.55\u00b10.02 and 0.60\u00b10.03; AUPRC 0.22\u00b10.02 and 0.21\u00b10.03 for Centers 2 and 3, respectively). Nevertheless, analysis of the external cohort showed significantly higher probability of CM in high\u2010 versus low\u2010risk groups (hazard ratio 2.78, 95% CI = 1.52\u20135.10,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.00056).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Deep learning models have the potential to identify subtle echocardiographic markers years before CM diagnosis in pediatric cancer survivors and could serve as a preliminary step toward risk\u2010guided CM surveillance. Further refinement and validation are needed to determine the utility of deep learning for early identification of pathologic cardiac remodeling in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/echo.70643","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T07:32:28Z","timestamp":1792654348000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early Prediction of Cardiomyopathy in Pediatric Cancer Survivors Using Echocardiographic Video\u2010Based Deep Learning"],"prefix":"10.1111","volume":"43","author":[{"given":"Surbhi","family":"Sharma","sequence":"first","affiliation":[{"name":"Department of Bioengineering University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandy","family":"Martinez Di Pietro","sequence":"additional","affiliation":[{"name":"Seattle\u00a0Children's Hospital  Seattle 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aarti","family":"Bhat","sequence":"additional","affiliation":[{"name":"Seattle\u00a0Children's Hospital  Seattle Washington USA"},{"name":"Department Of\u00a0Pediatrics University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Blythe","sequence":"additional","affiliation":[{"name":"Clinical Research and Public Health Sciences Divisions Fred Hutchinson Cancer Center  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Border","sequence":"additional","affiliation":[{"name":"Department Of\u00a0Pediatrics Emory University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kasey J.","family":"Leger","sequence":"additional","affiliation":[{"name":"Seattle\u00a0Children's Hospital  Seattle Washington USA"},{"name":"Department Of\u00a0Pediatrics University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy M.","family":"Leisenring","sequence":"additional","affiliation":[{"name":"Clinical Research and Public Health Sciences Divisions Fred Hutchinson Cancer Center  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lillian R.","family":"Meacham","sequence":"additional","affiliation":[{"name":"Department Of\u00a0Pediatrics Emory University  Atlanta Georgia USA"},{"name":"Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta and Department of Pediatrics Emory University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanti","family":"Narasimhan","sequence":"additional","affiliation":[{"name":"Department Of\u00a0Pediatrics University of Minnesota, Masonic\u00a0Children's Hospital  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul C.","family":"Nathan","sequence":"additional","affiliation":[{"name":"Department Of\u00a0Pediatrics University of Toronto, The Hospital for Sick\u00a0Children  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritu","family":"Sachdeva","sequence":"additional","affiliation":[{"name":"Department Of\u00a0Pediatrics Emory University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karim","family":"Sadak","sequence":"additional","affiliation":[{"name":"Department Of\u00a0Pediatrics University of Minnesota, Masonic\u00a0Children's Hospital  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayla","family":"Stratton","sequence":"additional","affiliation":[{"name":"Clinical Research and Public Health Sciences Divisions Fred Hutchinson Cancer Center  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric 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Regenerative Medicine University of Washington  Seattle Washington USA"},{"name":"Center For Cardiovascular Biology University of Washington  Seattle Washington 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S.Yadav andK.Bhagtani \u201cGeneration of Synthetic Echocardiograms Using Video Diffusion Models \u201d In2024 IEEE Southwest Symposium on Image Analysis and Interpretation (SSIAI)(IEEE 2024) 33\u201336 https:\/\/doi.org\/10.1109\/ssiai59505.2024.10508643.","DOI":"10.1109\/SSIAI59505.2024.10508643"}],"container-title":["Echocardiography"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.70643","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/echo.70643","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.70643","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T07:32:30Z","timestamp":1792654350000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/echo.70643"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":41,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/echo.70643"],"URL":"https:\/\/doi.org\/10.1111\/echo.70643","archive":["Portico"],"relation":{},"ISSN":["0742-2822","1540-8175"],"issn-type":[{"value":"0742-2822","type":"print"},{"value":"1540-8175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-06-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70643"}}