Coronary CT Angiography

 

Purpose

Quantification of stenosis of the coronary arteries

Tag(s)


Panel

Cardiac

Define-AI ID

19040030

Originator

Kimberly Brockenbrough, MD

Lead

Kimberly Brockenbrough, MD

Panel Chair

Carlo De Cecco, MD

Panel Reviewers

Cardiac Panel

License

Creative Commons 4.0 

Status

Public Comment

RadElement Set RDES145

Clinical Implementation


Value Proposition

Coronary CT Angiography offers opportunities to minimize patient risk compared to invasive coronary angiography in efforts to diagnosis coronary artery disease. While improvements in image quality have been made recently, AI that delivers metrics related to CTA would be promising for clinician efficiency and patient outcomes. Currently CTA faces some challenges to invasive procedures such as lower temporal resolution, greater frequency of motion artifacts, and higher false-positives from severe calcification.

Narratives

A 55 year old woman presents to the emergency department with chest pain. Initial blood work is negative for a myocardial infarction (heart attack). She has a history of high cholesterol putting her at an intermediate risk for an acute myocardial infarction. Her doctor orders an ECG that appears normal. A coronary CTA is ordered to look for coronary artery disease.
A 60 year old man presents to his primary care physician with a 3 week history of chest pain. Blood work and EKG are negative. The nuclear stress test is equivocal. His doctor orders a coronary CTA to look for coronary artery disease.

Workflow Description

The image is obtained from the CT scanner, sent to the AI algorithm and to the PACS. The CT images are post-processed by the algorithm. The algorithm measures the minimum diameter of the coronary arteries. The post-processed images are sent to the PACS.

Considerations for Dataset Development



Procedure(s)

{CTA coronary arteries}

View(s)

{<1 mm axial source images and 3D reconstructions}

Sex at Birth

{Male, Female}

Age

[0,105]

Technical Specifications


Inputs

DICOM Study

Procedure

CT angiogram of the coronary arteries

Views

< 1 mm axial slices

Data Type

DICOM

Modality

CT

Body Region

Heart

Anatomic Focus

Coronary arteries



Primary Outputs

 

Percent Stenosis of the Coronary Arteries

RadElement ID

RDE969

Definition

Determine degree of stenosis

Data Type

Numeric

Value Set

[0,100]

Units

percentage


Maximum Percent Stenosis of the left main coronary artery

RadElement ID

RDE970

Definition

Percent stenosis compared to the adjacent normal vessel

Data Type

Numeric

Value Set

[0,100]

Units

percentage



Maximum percent stenosis of the left anterior descending coronary artery

 

RadElement ID

RDE971

Definition

percent stenosis compared to the adjacent normal vessel

Data Type

Numeric

Value Set

[0,100]

Units

percentage

 

 

Minimum percent stenosis of the diagonal branches


RadElement ID

RDE972

Definition

percent stenosis compared to the adjacent normal vessel

Data Type

Numeric

Value Set

[0,100]

Units

percentage

 

 

Minimum percent stenosis of the ramus branch

RadElement ID

RDE973

Definition

percent stenosis compared to the adjacent normal vessel

Data Type

Numeric

Value Set

[0,100]

Units

percentage

 

 

Minimum percent stenosis of the left circumflex artery

 

RadElement ID

RDE974

Definition

percent stenosis compared to the adjacent normal vessel

Data Type

Numeric

Value Set

[0,100]

Units

percentage

 

 

Minimum percent stenosis of the obtuse marginal branch

 

RadElement ID

RDE975

Definition

percent stenosis compared to the adjacent normal vessel

Data Type

Numeric

Value Set

[0,100]

Units

percentage

 

 

Minimum percent stenosis of the right coronary artery


RadElement ID

RDE976

Definition

percent stenosis compared to the adjacent normal vessel

Data Type

Numeric

Value Set

[0,100]

Units

percentage

 

 

Minimum percent stenosis of the PDA

 

RadElement ID

RDE977

Definition

percent stenosis compared to the adjacent normal vessel

Data Type

Numeric

Value Set

[0,100]

Units

percentage

 

 

Minimum percent stenosis of the posterior lateral branch

 

RadElement ID

RDE978

Definition

percent stenosis compared to the adjacent normal vessel

Data Type

Numeric

Value Set

[0,100]

Units

percentage

 

 

 

Future Development Ideas


  • The algorithm could give CAD-RADs categories