Craniosynostosis

Purpose

Identify premature closure of cranial sutures

Tag(s)

 

Panel

Pediatric Panel

Define-AI ID

19010006

Originator

Neil Lall
Lead Neil Lall

Panel Chair

Matt Hawkins

Panel Reviewers

Pediatric Panel

License

Creative Commons 4.0 
Status Public Commenting
RadElement Set RDES92
                               

Clinical Implementation


Value Proposition

Craniosynostosis is a premature closure of the cranial sutures, with resulting deformity of the skull which can result in cosmetic issues and increased intracranial pressure. Early identification and cranioplasty can often alleviate these issues; however, identification of premature fusion can be difficult due to the differing milestones of normal sutural fusion for the multiple sutures. An algorithm meeting this use case will identify premature sutural fusion and abnormal sutural ridging. This automated detection will improve radiologists’ ability to focus on identifying possible sequelae of craniosynostosis and associated abnormalities as seen in syndromic conditions.

Narrative(s)

An infant presents with an abnormal head shape; the physician wants to ensure that this is related to positional flattening of the skull and not an underlying abnormal sutural fusion.

Workflow Description

A CT is performed and sent to PACS and the AI engine. The algorithm is triggered automatically by a head CT. The craniosynostosis algorithm returns an identification of any sutures that are prematurely closed or have associated ridging.


Considerations for Dataset Development



Procedures(s)

{CT Head of the skull}

View(s)

All

Sex at Birth

{Male, Female}

Age

[0,4]

Technical Specifications


Inputs

 

DICOM Study

Procedure

Head CT

Views

All

Data Type

DICOM

Modality

CT

Body Region

Head

Anatomic Focus

Skull


Patient Age

Data Type

Numeric




Primary Outputs


Metopic

RadElement ID

RDE552

Definition

Status of the midline frontal (metopic) suture

Data Type

Categorical

Value Set

0 - Undetermined

1 - Open, normal for age

2 - Closed, normal for age

3 - Open, abnormal for age

4 - Closed, abnormal for age

5 - Closed with ridging

Units

N/A



Sagittal

RadElement ID

RDE553

Definition

Status of the midline sagittal suture

Data Type

Categorical

Value Set

0 - Undetermined

1 - Open, normal for age

2 - Closed, normal for age

3 - Open, abnormal for age

4 - Closed, abnormal for age

5 - Closed with ridging

Units

N/A


Right Coronal

RadElement ID

RDE554

Definition

Status of the right coronal suture

Data Type

Categorical

Value Set

0 - Undetermined

1 - Open, normal for age

2 - Closed, normal for age

3 - Open, abnormal for age

4 - Closed, abnormal for age

5 - Closed with ridging

Units

N/A



Left Coronal

RadElement ID

RDE555

Definition

Status of the left coronal suture

Data Type

Categorical

Value Set

0 - Undetermined

1 - Open, normal for age

2 - Closed, normal for age

3 - Open, abnormal for age

4 - Closed, abnormal for age

5 - Closed with ridging

Units

N/A



Right Lambdoid

RadElement ID

RDE551

Definition

Status of the right lambdoid suture

Data Type

Categorical

Value Set

0 - Undetermined

1 - Open, normal for age

2 - Closed, normal for age

3 - Open, abnormal for age

4 - Closed, abnormal for age

5 - Closed with ridging

Units

N/A




Left Lambdoid

RadElement ID

RDE556

Definition

Status of the left lambdoid suture

Data Type

Categorical

Value Set

0 - Undetermined

1 - Open, normal for age

2 - Closed, normal for age

3 - Open, abnormal for age

4 - Closed, abnormal for age

5 - Closed with ridging

Units

N/A


Right Squamosal


RadElement ID

RDE557

Definition

Status of the right squamosal/temporosquamosal suture

Data Type

Categorical

Value Set

0 - Undetermined

1 - Open, normal for age

2 - Closed, normal for age

3 - Open, abnormal for age

4 - Closed, abnormal for age

5 - Closed with ridging

Units

N/A


Left Squamosal


RadElement ID

RDE558

Definition

Status of the left squamosal/temporosquamosal suture

Data Type

Categorical

Value Set

0 - Undetermined

1 - Open, normal for age

2 - Closed, normal for age

3 - Open, abnormal for age

4 - Closed, abnormal for age

5 - Closed with ridging

Units

N/A




Secondary Outputs


Wormian bones


RadElement ID

RDE559

Definition

Presence of wormian bones

Data Type

Categorical

Value Set

0 - absent

1 - 1-10 wormian bones present (within normal limits)

2 - more than 10 wormian bones (abnormal)

3- Unknown

Units

N/A

Future Development Ideas


  • Identification of normal sutures (and normal variant accessory sutures) for patient age can be useful in distinguishing them from fractures. 

  • Identification of sutures on radiographs would be very useful to help in looking for craniosynostosis (as well as distinguishing from fractures).

  • other secondary findings such as orbital shape (e.g. harlequin orbit) or overall skull morphology would be useful to highlight to assist with more equivocal cases.

  • While MRI is not the common method for such evaluations, a reliable method of assessment on MRI would be beneficial in allowing it to be used for these cases.