Calcium Scoring of the Aortic Valve before TAVR


Purpose

Identify the aortic valve and measure the Calcium score, and suggest follow up care(TAVR vs. SAVR) in routine TAVR CT reports.

Tag(s)


Panel

Cardiac

Define-AI ID

19040035

Originator

Moritz H. Albrecht

Lead

Moritz H. Albrecht

Panel Chair

Carlo De Cecco

Panel Reviewers

Cardiac Panel

License

Creative Commons 4.0 

Status

Public Comment

RadElement Set RDES129 

Clinical Implementation


Value Proposition

More recently, the value of Calcium scoring for the decision TAVR vs. SAVR has been particularly recognized and implemented in guidelines. However, the measurement adds another work burden in manual 3D post-processing, despite the assumption that calcium scoring of the aortic valve could be easier performed than for the coronary arteries.
The amount of calcification of the aortic valve and left ventricular outflow tract can be quantified taking the Agatston convention into account. The algorithm will automatically identify the aortic valve and measure the Calcium score, and suggest the result (TAVR vs. SAVR) in routine TAVR CT reports- which will likely increase the efficiency of clinicians, improve patient outcomes, and minimize patient risk.

Narrative(s)

TAVR CT reports will be more comprehensive in terms of quantitative information and the radiologist/ cardiologist can focus more on qualitative criteria when analyzing the TAVR CT dataset prior to the procedure.

Workflow Description

Patient receives TAVR CT examination. Algorithm segments image to identify the aortic valve on usual TAVR CT examinations. Algorithm detects calcifications in the volume of interest. For each calcification, the algorithm quantifies the amount of calcium according to the Agatston convention. Following which, the algorithm then provides the calcium score and cautiously suggests the TAVR or SAVR approach.

Considerations for Dataset Development



Procedure(s)

Gated CTA of the chest

View(s)

CCTA Any volumetric imaging data set

Sex at Birth

{Male, Female}

Age

[18,70]

History

Severe Aortic stenosis

CT

Must be gated with multiple diastolic and systolic phases of the cardiac cycle

Contrast Material

{CT w/ IV arterial-phase contrast, w/o arterial-phase contrast}

Position

{Weight bearing, nonweight bearing}

Technical Specifications


Inputs



DICOM Study

Procedure

TAVR CT

Views

N/A

Data Type

DICOM

Modality

CT

Body Region

Chest

Anatomic Focus

Heart



Primary Outputs


Detect Calcifications of interest

RadElement ID

RDE851

Definition

Detect calcification in the region of interest

Data Type

Categorical

Value Set

  • Calcification absent
  • Calcification present
  • Unknown

Units

N/A



Calcium score according to Agatston convention

RadElement ID

RDE852

Definition

Calcium score according to Agatston convention

Data Type

Numeric

Value Set

  • Acute aortic syndrome absent
  • Acute aortic syndrome present
  • Unknown

Units

N/A



Recommended treatment with respect to calcification

RadElement ID

RDE853

Definition

Recommended treatment with respect to calcification

Data Type

Categorical

Value Set

  • TAVR
  • SAVR
  • Unknown

Units

N/A