Expert-level localization of fine-grained cardiac structures across the transthoracic echocardiogram

Artificial intelligence models for echocardiography interpret studies without identifying the structures that support their outputs. We show that this spatial grounding does not emerge from the pretraining of current vision-language models. General-purpose and medical vision-language models and an open-vocabulary detector recalled 3% or fewer of cardiac structures and scored below a box that never sees the image. EchoLens, a detector trained on 5,912 expert-annotated structures and 4,219 Doppler signals from 136 patients, recalled 87% and localized structures as reliably as a blinded expert re

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