Left Atrial Size

Purpose

Automate left atrial size measurements on CT

Tag(s)

Panel

 Cardiac

TOUCH-AI ID

 TAI-04180007

Originator

 Jay Nance

Panel Chair

 Carlo De Cecco

Panel Reviewers

 Cardiac Panel

License

 Creative Commons 4.0

Status  Public Commenting

Clinical Implementation


Value Proposition

Evaluation of left atrial (LA) size is important to identify global cardiac abnormalities and intrinsic abnormalities of the left atrium and to suggest valvular disease. Cardiac CT angiography (CCTA) allows for accurate LA morphological assessment. Automated LA size quantification would save the interpreting physician time by eliminating manual measurements and preventing detection errors and would provide structured quantitative data that could be used in later studies or risk stratification schemes.

Narrative(s)

All patients undergoing CCTA examinations should have automated quantification of LA size if data are available, which may then be automatically populated into the radiology report or a report supplement.

Workflow Description

The patient receives ECG-synchronized CCTA of the heart. The algorithm retrieves the imaging data set and may ingest additional electronic medical record data such as age, sex, and body surface area (BSA). The algorithm calculates local values for LA size during diastole and systole. Both indexed volumes (ie, normalized to BSA) and absolute anteroposterior diameter should be reported. Volumes should be reported at end-systole and end-diastole if available. All future references to end-systole and end-diastole refer to ventricular systole and diastole, as per convention. The algorithm returns all measurements.

Considerations for Dataset Development


Procedures(s): ECG-synchronized cardiac CT

View(s): CCTA – volumetric imaging dataset

 

Sex at Birth: {Male, Female}

 

Age (years): [15,100]

 

Body Surface Area (m2): [1,3]

 

Comorbidities: {Congenital heart disease, Ventricular septal defects}

 

Intervention: Congenital heart disease repair

 

Other: Contrast-enhanced (CCTA)

Technical Specifications


Inputs

DICOM Study

Procedure

ECG-synchronized cardiac CT

Views

CCTA – volumetric imaging dataset

Data Type

DICOM

Modality

CT

Body Region

Chest

Anatomic Focus

Heart

 

Primary Outputs

Left Atrial Volume During End Systole

RadElement ID

RDE302

Definition

Measure LA volume during end-systole (ventricular systole), where it should be highest, and normalize to BSA

Data Type

Numeric

Value Set

 

Units

mL3

 

Left Atrial Volume during End Diastole

RadElement ID

RDE303

Definition

Measure LA volume (mL3) during end-diastole (ventricular diastole), where it should be lowest, and normalize to BSA

Data Type

Numeric

Value Set

 

Units

mL3

 

Left Atrial Diameter during End Systole

RadElement ID

RDE304

Definition

Measure LA diameter during end-systole (ventricular systole), where it should be highest

Data Type

Numeric

Value Set

 

Units

mm

 

Left Atrial Ejection Fraction

RadElement ID

RDE305

Definition

Ejection fraction (%) calculated as follows: (end-systolic volume – end-diastolic volume) / (end-systolic volume).

Data Type

Numeric

Value Set

[0,1]

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.