Ascending Aortic Diameter

Purpose

Automate ascending aortic diameter measurement

Tag(s)

#MPA:AO 

Panel

Cardiac 

TOUCH-AI ID

TAI-04180001

Originator

Jay Nance 

Panel Chair

Carlo De Cecco 

Panel Reviewers

Cardiac Panel 

License

Creative Commons 4.0 

Status  Public Commenting
                               

Clinical Implementation


Value Proposition

Pulmonary artery size is an imperfect imaging biomarker of pulmonary hypertension but has shown prognostic value in a variety of clinical situations. Cutoffs for abnormal values have been proposed and validated. Automated quantification would save the interpreting physician time via elimination of manual measurements, would prevent detection errors (missing enlarged pulmonary arteries), and would provide structured quantitative data, which could be used in later studies or risk-stratification schemes.

Narrative(s)

All patients undergoing CT examinations through the level of the main pulmonary artery should have automated quantification of arterial diameter, which should then be automatically populated into the radiology report or a report supplement. This use case will focus specifically on relevant cardiac imaging modalities, ie, electrocardiogram (ECG)-synchronized coronary artery calcium scoring, coronary CT angiography (CCTA), and full-chest CT angiography (triple rule-out scans).

Workflow Description

A patient receives ECG-synchronized CT of the chest and heart. An algorithm retrieves a volumetric imaging data set and accessible electronic medical record data, including age, sex, and body mass index. The algorithm executes and returns the following measurements: the ascending aorta at the level of the main pulmonary artery. An additional measurement is the proximal right and left pulmonary arteries. Please note, these values have shown limited value in the literature, and this feature should be considered optional. The algorithm returns all values, which could populate the report (possibly within a supplement containing other quantitative data). The algorithm flags abnormal values.

Considerations for Dataset Development


Procedures(s): ECG-synchronized CT, Chest

Sex at Birth: {Male, Female}

 

Age (years): [15,90]

 

Body Mass Index (kg/m2): [10,52]

 

Body Surface Area: varied

 

Aortic Diameter (mm): [20,40]

 

Abnormalities: {Congenital heart disease, ventricular septal defects}

 

Interventions: {Congenital heart disease repair, mitral valve replacements}

 

Contrast: {Contrast-enhanced (CCTA), non-contrast enhanced applications}

Technical Specifications


Inputs

DICOM Study

Procedure

ECG-synchronized CT, Chest

Data Type

DICOM

Modality

CT

Body Region

Chest

Anatomic Focus

Heart

 

Primary Outputs

Ascending Aortic Diameter

RadElement ID

RDE291 

Definition

Diameter of ascending aorta at the level of the main pulmonary artery (mm)

Data Type

Numeric

Value Set

 

Units

mm

Secondary Outputs

Pulmonary Artery to Aortic Diameter Ratio

RadElement ID

RDE318

Definition

Main pulmonary artery to aortic diameter ratio (MPA:Ao)

Data Type

Numeric

Value Set

 

Units

 

Public Commenting


Use cases are meant to be a primary vehicle for distributing clinical information to the developer community. They pinpoint precise scenarios within radiology workflows where potential automation could add noticeable value and establish standards for interpreting and passing corresponding common data elements. Implementing effective standards requires the perspective from all stakeholders. So to that end, we encourage your feedback on use cases.

To submit comments, please email DSIUseCases@acr.org with the use case title(s) and relevant comments by January 1, 2019. If more convenient, you may also download this use case and comment directly on the PDF. Just attach the PDF copy on the email.