Abstract 17760: Conversion of Dicom ECG Images to Tabular Format for Building Large Language Model in Diagnoses and Disease Progression of Cardiovascular Conditions

Introduction: DICOM Electrocardiography (ECG) images from individuals are routinely stored at the institutional PACS server, including normal and abnormal findings. Hypothesis: The study’s objective is to create a database of ECGs as per Standard Communication Protocol (SCP) and to build an accurate Large Language Model (LLM) across different cardiovascular conditions Methods: DICOM ECGs are retrieved, anonymized and labelled to convert the signals to (x, y) coordinates with the help of PyDicom libraries. The tabular format is then stored with lead definition and dimensions of duration and amplitude, metadata, clinical conditions, and textual diagnoses. Results: In the pilot study, 1308 ECGs from individuals with different age (<45 & >45 years), gender (male & female), binary clinical categories (normal & abnormal) and heart rate (<90 & >90 per min) are selected for analysis and modeling. The DICOM image signal reproducibility following conversion (Figure 1 & 2) shows Cross Correlation Percentage of 0.85 (0.76 - 0.94) (Figure 3). An eXtreme Gradient Boosting (XGBoost) model (6) was trained to predict above variables. The results (Figure 4) show AUC highest for predicting binary clinical categories (normal vs abnormal) at 0.81 (0.7 - 0.9) and lowest for predicting age (<45 & >45 years) at 0.6 (0.46 - 0.7). The accuracies in the leads also show similar trend. The limitations include reproducibility of results in Lead VIII, IX and XI, which are sub average and hence being retrained with optimizers. These are initial results with relatively smaller database where multiclass disease or condition classifications are not performed. Conclusions: To conclude, the methodology possesses opportunities to improve the model with Deep Learning and Entity Disambiguation Techniques (NLP) to build Large Language ECG Models for cardiovascular diagnoses and disease progression trajectories.