EchoPOSE: 6D Pose Estimation of Sparse Echocardiograms for Left-Ventricular 3D Shape Reconstruction

3D echocardiography provides superior cardiac quantification to traditional 2D echocardiography, which suffers from geometric idealizations and imaging plane misalignment. However, despite its advantages, clinical adoption of 3D echo remains limited due to logistical and visualization challenges. We propose a novel framework that reconstructs the 3D shape of the left ventricle (LV) throughout the cardiac cycle from sparse 2D echocardiographic views routinely acquired in clinical practice, without the need for external hardware or manual tracking. Our method integrates EchoPOSE, a new deep network that automatically estimates the 6D pose (position and orientation) of LV segmentations, with a graph-harmonic algorithm for 3D shape reconstruction. EchoPOSE employs a transformer-based architecture that combines local image features with global multi-view context, and introduces a geometry-aware loss to ensure spatial consistency across intersecting imaging planes. Trained and evaluated on large-scale synthetic data derived from 3D echocardiography and validated on prospectively acquired clinical echocardiograms, EchoPOSE achieves 3.78 mm and 8.65 pose errors, yielding 87.5% Dice reconstruction accuracy, 1.44% ejection fraction (EF) error, and 3.03% volume error, surpassing alternative deep learning techniques and classical clinical approaches. Notably, the framework remains robust under suboptimal imaging alignment, suggesting that EchoPOSE can reduce the sonography skills required for transducer positioning and allow minimally trained clinicians to perform echo scans.