Pulmonary Parenchymal Emphysema

Purpose

Detect and quantitate the type and amount of emphysema in each of the five lobes of the lung on thoracic CT scans

Tag(s)

 

Panel

Thoracic Panel

Define-AI ID

19080011

Originator

John Newell
Lead John Newell

Panel Chair

Eric Stern

Panel Reviewers

Thoracic Panel

License

Creative Commons 4.0 
Status Public Commenting
RadElement Set RDES105
                               

Clinical Implementation


Value Proposition


Quantitative CT assessment of emphysema in the lungs has been shown to correlate with decreases in pulmonary function, quality of life and increases in morbidity and mortality in patients with COPD. Emphysema has also been shown to be an independent risk factor for lung cancer. An AI algorithm that could assist the radiologist with this assessment would improve the efficiency of the radiologist and patient outcomes.

Narrative(s)


A 35 year old non-smoking woman with suspected pneumonia has a CT scan of the thorax. There is no evidence of pneumonia but the AI assessment indicates 35% by volume of pan lobular emphysema from alpha-1 anti-trypsin deficiency.
A 65-year-old active smoker with 35 pack-year smoking history received a screening LDCT which showed moderate upper lobe predominant emphysema and a 1.2 cm right upper lobe nodule with spiculated margin. The AI algorithm quantitates lobar distribution of emphysema and generates a structured report.

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 and estimates extent of emphysema. An alert message is sent to PACS from the engine with the information, identification, and graphic highlighting the emphysema.

Considerations for Dataset Development



Age

Varied

Sex at birth:

Male, Female

Smoking History

No, Yes

Chest hyperinflation

Absent, Present

Centrilobular emphysema

Absent, present

Panlobular emphysema

Absent, present

Paraseptal emphysema

Absent, present

Paracicatricial emphysema

Absent, present

Localized emphysema

Absent, present

Idiopathic giant bullous emphysema

Absent, present

Congenital lobar emphysema

Absent, present

Pulmonary interstitial emphysema

Absent, present

Pulmonary arterial hypertension

Absent, present

lymphangiomyomatosis

Absent, present

Pulmonary Langerhans cell histiocytosis

Absent, present

Honeycomb lung

Absent, present

Bronchial and bronchiolar wall thickening

Absent, present

Severe air trapping

Clinical note: can mimic emphysema

Absent, present

Technical Specifications


Inputs

DICOM Study

Procedure

Chest CT

Views

Axial, sagittal, coronal

Data Type

DICOM

Modality

CT

Body Region

Chest

Anatomic Focus

Thorax




Primary Outputs


Presence of emphysema

RadElement ID

RDE675

Definition

Detection of emphysema in either lung

Data Type

Categorical

Value Set

  • Emphysema absent

  • Emphysema present

  • Unknown

Units

N/A


Emphysema in right lung

RadElement ID

RDE676

Definition

Detection of emphysema in right lung

Data Type

Categorical

Value Set

  • Emphysema absent

  • Emphysema present

  • Unknown

Units

N/A


Emphysema in left lung

RadElement ID

RDE677

Definition

Detection of emphysema in left lung

Data Type

Categorical

Value Set

  • Emphysema absent

  • Emphysema present

  • Unknown

Units

N/A



Emphysema in left upper lobe

RadElement ID

RDE678

Definition

Detection of emphysema in left superior lobe

Data Type

Categorical

Value Set

  • Emphysema absent

  • Emphysema present

  • Unknown

Units

N/A

Emphysema in left lower lobe

RadElement ID

RDE679

Definition

Detection of emphysema in left inferior lobe

Data Type

Categorical

Value Set

  • Emphysema absent

  • Emphysema present

  • Unknown

Units

N/A


Emphysema in right upper lobe

RadElement ID

RDE680

Definition

Detection of emphysema in right superior lobe

Data Type

Categorical

Value Set

  • Emphysema absent

  • Emphysema present

  • Unknown

Units

N/A

Emphysema in right middle lobe

RadElement ID

RDE681

Definition

Detection of emphysema in right middle lobe

Data Type

Categorical

Value Set

  • Emphysema absent

  • Emphysema present

  • Unknown

Units

N/A


Emphysema in right lower lobe

RadElement ID

RDE682

Definition

Detection of emphysema in right inferior lobe

Data Type

Categorical

Value Set

  • Emphysema absent

  • Emphysema present

  • Unknown

Units

N/A




Secondary Outputs


Percent of lung zone involvement with emphysema

RadElement ID

RDE655

Definition

For any detected emphysema, measure the percent of the lobe with emphysema

Data Type

Numeric

Value Set

[0,1]

Units

Percent of lung lobe with emphysema



Dominant Type of emphysema

RadElement ID

RDE683

Definition

Dominant type of emphysema

Data Type

Categorical

Value Set

  • centriacinar

  • panacinar

  • paraseptal

Units

N/A


Percent volume of each emphysema type

RadElement ID

RDE656

Definition

Percent volume of each emphysema type (centriacinar, panacinar, and paraseptal)

Data Type

Numeric

Value Set

[0,1]

Units

percent volume of lung