Acute Aortic Syndrome


Purpose

Acute aortic syndromes (AAS), including acute aortic dissection are life-threatening emergencies affecting about 10,000 cases per year in the United States.

Tag(s)


Panel

Cardiac Panel

Define-AI ID

19040026

Originator

External Use Case Submission from Cleveland Clinic

Panel Chair

Carlo De Cecco

Panel Reviewers

Cardiac Panel

License

Creative Commons 4.0

Status

Public Comment

Clinical Implementation


Value Proposition

Acute aortic dissection has high early mortality with a death rate as high as 1% per hour during the first 24 hours. Automatic detection improves time-to-intervention and thereby improves mortality.

Narrative(s)

A patient arriving to ED with pleuric chest pain. Differential diagnosis is wide. The patient receives chest CT. Automation allows parallel triggering of the AAS management, and prioritization on the radiologist worklist for immediate review.

Workflow Description

The image is obtained from modality and sent to PACS and the AI engine. The image is analyzed by the engine. The system then detects probability of acute aortic syndrome. An alert message is sent to PACS from the engine with the information, identification, and graphic highlighting the features of the image that are most influential to the model prediction.

Considerations for Dataset Development



Aortic Dissection

{acute, subacute, chronic}

Ischemia

{abdominal organ ischemia, limb ischemia, ischemic or embolic stroke, paraplegia}

Comorbidities

{hypertension, inherited connective tissue disorder, atherosclerosis, vasculitis, coronary artery disease, chronic obstructive pulmonary disease}

Aortic emergencies

{Aortic dissection, aortic intramural hematoma, penetrating atherosclerotic ulcer, aortic aneurysmal rupture, traumatic thoracic aortic injury, traumatic abdominal aortic injury}

Smoking history

{Yes, No}

Aortic aneurysmal rupture

{Intraperitoneal rupture, retroperitoneal rupture, aortocaval fistula, primary aorto-enteric fistula}

Technical Specifications


Inputs

DICOM Study

Procedure

CT

Views

Axial, Coronal, Sagittal

Data Type

DICOM

Modality

CT

Body Region

Chest

Anatomic Focus

Heart

Pharmaceutical


Scenario





Primary Outputs

Acute aortic syndrome

RadElement ID


Definition

presence of acute aortic syndrome

Data Type

Categorical

Value Set

0-Acute aortic syndrome absent

1-Acute aortic syndrome present

2-Unknown

Units

N/A


Stanford classification

RadElement ID


Definition

Classification of an acute aortic syndrome

Data Type

Categorical

Value Set

0- Stanford A

1- Stanford B

2- Unknown

Units



Secondary Outputs

Acute aortic syndrome segmentation

RadElement ID


Definition

Graphical overlay of the features that suggest acute aortic syndrome

Data Type

Coordinates

Value Set


Units