Left Ventricle Volume

Purpose

Automate standard left ventricle volumetric measurements

Tag(s)

#LV Functional Assessment

Panel

Cardiac

TOUCH-AI ID

TAI-04180010

Originator

Carlo De Cecco

Panel Chair

Carlo De Cecco

Panel Reviewers

Cardiac Panel

License

Creative Commons 4.0

Status Public Commenting

Clinical Implementation


Value Proposition

The measurement of left ventricular (LV) function is a well-established clinical parameter that has fundamental diagnostic, therapeutic, and prognostic implications. Cardiac CT angiography (CCTA) and cardiac magnetic resonance (CMR) allow for accurate LV morphological and functional assessment. Automated LV function quantification would save the interpreting physician time by eliminating manual measurements, preventing detection errors, and providing structured quantitative data, which could then be used in later studies or risk-stratification schemes.

Narrative(s)

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

Workflow Description

A patient receives ECG-synchronized CCTA of the heart. An algorithm retrieves the imaging data set and may ingest other electronic medical records (EMR) data such as age, sex, and body surface area (BSA). The algorithm calculates the absolute LV end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF), cardiac output (CO), and myocardial mass. With BSA, the algorithm computes indexed LV EDV, LV ESV, and myocardial mass. The algorithm returns all measurements to the radiologist. Absolute and indexed EDV, ESV, EF, CO, and myocardial mass may automatically populate the report, possibly within a supplement containing other quantitative data.

Considerations for Dataset Development


Procedures(s): ECG-synchronized cardiac CT

 

View(s): CCTA: Any volumetric imaging data set

 

Sex at Birth: {Male, Female}

 

Age: [15,90]

 

Body Surface Area: varied

 

Heart Abnormalities: {Congenital heart disease, ventricular septal defects, congenital heart disease repair, mitral valve replacements}

 

Contrast Material: {Contrast-enhanced (CCTA), noncontrast enhanced applications}

Technical Specifications


Inputs

DICOM Study

Procedure

ECG-synchronized cardiac CT

Views

CCTA: Any volumetric imaging data set

Data Type

DICOM

Modality

CT

Body Region

Chest

Anatomic Focus

Heart

 

Primary Outputs

End Diastolic Volume

RadElement ID

RDE218

Definition

Measure LV end-diastolic volume

Data Type

Numeric

Value Set

[0,200]

Units

mL

 

End Systolic Volume

RadElement ID

RDE219

Definition

Measure LV end-systolic volume

Data Type

Numeric

Value Set

[0,200]

Units

mL

 

Ejection Fraction

RadElement ID

RDE220

Definition

LV ejection fraction, calculated dividing stroke volume by the end-diastolic volume (%). The stroke volume is calculated subtracting LV ESV from LV EDV (EDV-ESV)

Data Type

Numeric

Value Set

[0,1]

Units

%

 

Indexed End Diastolic Volume

RadElement ID

RDE221

Definition

LV end-diastolic volume indexed to body surface area (mL/m2)

Data Type

Numeric

Value Set

[0,100]

Units

mL/m2

 

Indexed End Systolic Volume

RadElement ID

RDE222

Definition

LV end-systolic volume indexed to body surface area (mL/m2)

Data Type

Numeric

Value Set

[0,100]

Units

mL/m2

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.