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Clinical approaches for quantification of atrial fibrosis are currently based on digital image processing of magnetic resonance images. Here, we introduce and evaluate a comprehensive framework based on convolutional neural networks for quantifying atrial fibrosis from images acquired with catheterized fiber-optics confocal microscopy (FCM). FCM images in three regions of the atria were acquired in the beating heart in situ in an established transgenic animal model of atrial fibrosis. Fibrosis in the imaged regions was histologically assessed in excised tissue. FCM images and their corresponding histologically-assessed fibrosis levels were used for training of a convolutional neural network. We evaluated the utility and performance of the convolutional neural networks by varying parameters including image dimension and training batch size. In general, we observed that the root-mean square error (RMSE) of the predicted fibrosis was decreased with increasing image dimension. We achieved a RMSE of 2.6% and a Pearson correlation coefficient of 0.953 when applying a network trained on images with a dimension of 400 × 400 pixels and a batch size of 128 to our test image set. The findings indicate feasibility of our approach for fibrosis quantification from images acquired with catheterized FCM using convolutional neural networks. We suggest that the developed framework will facilitate translation of catheterized FCM into a clinical approach that complements current approaches for quantification of atrial fibrosis.

Towards Automated Quantification of Atrial Fibrosis in Images from Catheterized Fiber-Optics Confocal Microscopy Using Convolutional Neural Networks