Identification and Characterization of Vena Cava Filters


Purpose

Tool to automatically identify and characterize (type, location, potential complications) vena cava filters on imaging studies.

Tag(s)


Panel

Interventional Radiology

Define-AI ID

19090001

Originator

Jeremy C. Durack, MD

Lead

Jeremy C. Durack, MD

Panel Chair

Jeremy C. Durack, MD; Rajesh Shah, MD

Panel Reviewers

Interventional Radiology Panel

License

Creative Commons 4.0 

Status

Public Comment

RadElement Set  RDES104

Clinical Implementation


Value Proposition


The majority of vena cava filters placed today are retrievable, though it is known that filters are often not retrieved even when clinically appropriate. Identification and documentation of filter presence could trigger inclusion on a patient's problem list to encourage discussion regarding appropriate and timely retrieval. In addition, complications such as migration, fracture, thrombosis, and vena cava perforation are well known and detection may be facilitated using using machine learning techniques.

Narrative(s)


A patient with a history of deep venous thrombosis had a filter placed pre-operatively. The patient recovered from the procedure and has restarted anticoagulation. The mechanical filter is no longer required, however due to transitions of care teams, no one has taken responsibility for filter management. This tool would help to identify the presence of a filter and that information could be used to trigger appropriate management discussions as well as alert clinicians to potential filter-related complications.

Workflow Description


Abdominal x-ray or CT imaging of the abdomen performed. Automated detection of a filter, matched against training set of filters to determine type and location relative to the renal veins/vertebral bodies.

Considerations for Dataset Development



Procedure(s)

X-ray abdomen, CT abdomen

View(s)

All

Sext at Birth

Male, Female

Age

All

Indications for filter

varied

Filter indwelling time

varied

Filter Location

varied (see locations below in technical specifications)

Filter type

varied (see types below in technical specifications)

Filter injection route

varied

Technical Specifications


Inputs

DICOM Study

Procedure

X-ray, CT abdomen

Views

All

Data Type

DICOM

Modality

X-ray, CT

Body Region

Abdomen

Anatomic Focus

Vena cava

Pharmaceutical


Scenario

MRI may have limited utility in filter assessment due to metallic artifcacts



Primary Outputs


Filter Present

RadElement ID

RDE649

Definition

Presence of filter(s)

Data Type

Categorical

Value Set

  • Absent

  • Present

  • Unknown

Units

N/A

Filter Component count

RadElement ID

RDE646

Definition

Count of filter components

Data Type

Numeric

Value Set

N/A

Units

Number of components


Filter Type

RadElement ID

RDE651

Definition

For each filter identified, return the type of filter

Data Type

Categorical

Value Set

  • Option Elite filter

  • Gunther tulip filter

  • Celect filter

  • ALN filter

  • G2 filter

  • G2 X filter

  • Eclipse filter

  • Meridian filter

  • Sentry filter

  • OptEase filter

  • TrapEase filter

  • Recovery Option filter

  • Denali filter

  • VenaTech - LGM filter

  • VenaTech - LP filter

  • VenaTech Convertible filter

  • Simon Nitinol filter

  • Greenfield filter - stainless steel

  • Greenfield filter - titanium

  • Bird’s Nest filter

  • Other

Units

N/A



Filter or filter component location(s)

RadElement ID

RDE652

Definition

Anatomic location of filter(s) or filter component(s)

Data Type

Categorical (multi-select)

Value Set

  • Infrarenal vena cava

  • suprarenal vena cava

  • right common iliac vein

  • left common iliac vein

  • right testicular vein

  • left testicular vein

  • right ovarian vein

  • left ovarian vein

  • right renal vein

  • left renal vein

  • Superior vena cava

  • right atrium

  • right ventricle

  • left ventricle

  • interventricular septum

  • main pulmonary artery

  • right main pulmonary artery

  • left main pulmonary artery

  • segmental right pulmonary artery

  • segmental left pulmonary artery

  • other

Units

N/A




Secondary Outputs


Filter Complications

RadElement ID

RDE653

Definition

Radiographically evident filter complications

Data Type

Categorical (multi-select)

Value Set

  • Filter thrombosis

  • Filter tilt

  • Filter perforation

  • Filter fracture

  • Filter migration

  • Pulmonary embolism

  • Filter associated infection

  • Filter malposition

  • Incomplete deployment

Units

N/A

Future Development Ideas


Include features like:

  • Change of filter component location over time

  • Distinguish features of multiple filters or filter components present